Data Quality Specialist

Michael Garron Hospital; Toronto; On-site; CAD 90,000 - 120,000; Full time

Job summary

Michael Garron Hospital is seeking a Data Quality Specialist to lead coding quality and clinical documentation integrity under HBAM, HIG and QBP methodologies. The role ensures accurate ICD-10-CA/CCI coding, CMG/CMI/ELOS metrics, and robust audits using Crystal Reports, MS SQL Server and Power BI.

Collaborate with HIM, Decision Support, and Data Analytics to promote data integrity at the source and strengthen hospital funding reliability.

Qualifications

• Minimum 3–5 years of hospital coding and abstracting experience.
• Proficient in ICD-10-CA/CCI coding and CIHI DAD/NACRS abstraction.
• Knowledge of CMG, CMI, CACS, RIW and ELOS methodologies.
• Experience with HBAM, HIG and QBP funding mechanisms.
• Experience developing coding audits and documentation reviews.
• Experience collaborating with third‑party consultants on quality initiatives.

Responsibilities

• Lead data quality initiatives to enhance coding accuracy and documentation integrity.
• Perform and oversee coding audits and documentation reviews with cross‑functional teams.
• Develop advanced quality reporting and audit tools using Crystal Reports, SQL, Power BI.
• Collaborate with HIM, Clinical Programs, Decision Support and Data Analytics to ensure data reliability.
• Support hospital funding programs (HBAM, HIG, QBP) through accurate data abstraction.

Skills

Hospital coding

ICD-10-CA/CCI coding

CIHI DAD/NACRS

HBAM funding knowledge

Coding audits

Documentation reviews

Quality improvement

Data analysis

Education

Undergraduate degree in Health Information Management

CHIMA certification

Tools

Crystal Reports

MS SQL Server

Power BI

Python

Cerner reporting

Microsoft Office

Job description

Overview

The Data Quality Specialist is responsible for leading initiatives that enhance coding quality, clinical documentation integrity, and performance under QBP–HBAM–HIG methodologies. This role ensures the accuracy, completeness, and compliance of health data abstracted and submitted to the Canadian Institute for Health Information (CIHI) and the Ministry of Health (MOH). This position plays a key role in safeguarding hospital funding under HBAM, HIG, and QBP methodologies by ensuring the accurate assignment of ICD-10-CA/CCI codes, Case Mix Groups (CMG), Case Mix Index (CMI), Comprehensive Ambulatory Classification System (CACS), Resource Intensity Weights (RIW), and Expected Length of Stay (ELOS). The Specialist leads and executes data quality audits, including collaboration with third-party consultants, and develops advanced quality reporting and audit tools using Crystal Reports, MS SQL Server, Power BI, and other enterprise reporting systems. The position works closely with Health Information Management (HIM), Clinical Programs, Decision Support, and Data Analytics teams to promote data integrity at the source and ensure reliability across enterprise reporting and hospital performance monitoring.

Education

• Undergraduate Degree (minimum 3-year) in Health Information Management or related discipline.
• Active CHIMA certification in Health Information Management.

Experience

• Minimum 3-5 years of progressive experience in hospital coding and abstracting.
• Demonstrated ability to code in ICD-10-CA/CCI and abstract in the CIHI Discharge Abstract Database (DAD) and National Ambulatory Care Reporting System (NACRS).
• Demonstrated knowledge of CMG, CMI, CACS, RIW, and ELOS methodologies.
• Demonstrated experience with HBAM, HIG, and QBP funding methodologies.
• Experience developing and executing coding audits and documentation reviews.
• Experience working with third-party consultants on quality improvement initiatives.

Technical Competencies

• Demonstrated knowledge and ability to design reports using Crystal Reports.
• Demonstrated proficiency in MS SQL Server and SQL query development.
• Experience utilizing Python for data analysis and quality monitoring.
• Working knowledge of Cerner clinical systems and related reporting environments.
• Advanced knowledge of ICD-10-CA/CCI coding methodology.
• Strong working knowledge of HBAM, QBP, and hospital funding methodologies.
• Proficient in Microsoft Office applications including Word, Excel, and PowerPoint.
• Strong analytical, problem-solving, and data interpretation skills.
• All employees of Michael Garron Hospital (MGH), a division of Toronto East Health Network (TEHN) [formerly Toronto East General Hospital (TEGH)] agree to work within the legislated practices of the Occupational Healthand Safety Act of Ontario.
• All employees of MGH are responsible to contribute to a transparentculture of patient and staff safety by adhering to and abiding by patient and staff safety policies and procedures set by MGH.

EMPLOYMENT EQUITY & ACCESSIBILITY STATEMENT

Michael Garron Hospital (MGH) champions accessibility, diversity and equal opportunity through the creation of an inclusive and diverse work environment. At Michael Garron Hospital, we strive to be an equitable and inclusive employer. We encourage candidates from Black, First Nations, Métis and Inuit, racialized and LGBTQ2S+ communities, people of colour, women, people with disabilities and individuals who identify with the diverse communities that we serve, to join the MGH team.

Through our values of Compassion, Respect, Integrity, Inclusion and Courage, Michael Garron Hospital is committed to providing accessible employment practices that are in compliance with the Accessibility for Ontarians with Disabilities Act (AODA) and Ontario Human Rights Code (OHRC). Should you require an accommodation at any stage of the recruitment process, please let us know how we can work with you to meet your needs.

This job posting is a confirmed, active vacancy for which we are currently seeking a qualified candidate.

• All employees are accountable for protecting the psychological health and safety of themselves and their co-workers through adherence to MGH's policies and practices.

MGH is committed to leveraging new technologies and working efficiently. As a result, artificial intelligence systems may be used as part of our process to screen, assess, and or select applicants for this position.