Coding Quality Review Specialist

Crescent Tree Staffing Solutions; Nashville (TN); Remote; USD 60,000 - 100,000; Full time

Job summary

Join a forward-thinking organization as a Medical Coding Quality Assurance Lead. This full-time remote role offers the chance to work with a dedicated team focused on accuracy and compliance in medical coding. You will be responsible for performing quality assessments, leading coding reviews, and ensuring adherence to national guidelines. With over a decade of experience in medical coding and a commitment to ethical standards, this position provides a valuable opportunity to contribute to patient care excellence. If you are passionate about coding and quality assurance, this role is perfect for you.

Benefits

Medical Coverage

Dental Coverage

Vision Coverage

401(k)

Paid Time Off (PTO)

Qualifications

• 3+ years of hands-on MS-DRG auditing in a hospital setting.
• 10+ years of total medical coding experience preferred.

Responsibilities

• Lead and coordinate coding quality reviews for inpatient and outpatient coding.
• Ensure adherence to national guidelines and company coding policies.

Skills

Medical Coding

Quality Assessment

MS-DRG Auditing

Compliance

Team Collaboration

Education

Undergraduate degree in HIM/HIT

RHIA Certification

RHIT Certification

Job description

Our client is an industry leader in revenue cycle services, who is committed to delivering exceptional patient experiences.

This is a full-time, remote opportunity to contribute to an organization dedicated to ethical standards and industry leadership.

What will you do?

• Work with a team of experts focused on accuracy, integrity, and compliance in medical coding.
• Perform internal quality assessment reviews for Health Information Management Service Center (HSC) coders.
• Lead and coordinate all functions of coding quality reviews (routine, pre-bill, policy-driven, and incentive plan-driven) for inpatient and outpatient coding across multiple HSCs.
• Ensure coding staff adheres to national guidelines, HSC policies, and company coding policies.
• Apply expert-level knowledge of medical coding practices and concepts.
• Participate in special projects or reviews, maintaining accuracy and productivity standards (95% accuracy, 95% productivity).
• Keep coding knowledge current by reviewing official data quality standards, guidelines, policies, and clinical resources.

What will you need?

• Undergraduate degree in HIM/HIT preferred (Associate's or Bachelor's).
• Active RHIA, RHIT, and/or (mandatory).
• 3+ years of hands-on MS-DRG auditing in a hospital setting.
• 10+ years of total medical coding experience preferred.
• Demonstrated expertise across all body systems (not limited to one specialty, such as Orthopedics).
• Ability to pass a coding test: 20 multiple-choice/true-false and 5-7 behavioral questions (90 minutes).
• Reside in an eligible state (not available for California, Alaska, New York, or Colorado candidates).

Additional Information:

Competitive Salary, Medical, Dental, and Vision coverage 401(k), PTO.

Seniority level

Mid-Senior level

Employment type

Full-time

Job function

Quality Assurance and Health Care Provider

Industries

Staffing and Recruiting