Coding Quality review Specialist

DLM; Nashville (TN); Remote; USD 60,000 - 80,000; Full time

Job summary

A healthcare company is seeking a remote Coding Quality Review Specialist to review inpatient and outpatient medical coding for accuracy and compliance. The candidate should have over 10 years of hands-on coding experience and RHIA or RHIT certification. Responsibilities include various coding quality reviews, ensuring adherence to national guidelines, and maintaining high productivity and accuracy standards.

Qualifications

• 10+ years of hands-on medical coding experience required.
• 3+ years of inpatient MS-DRG auditing experience in a hospital setting.
• Must have coding experience in all body systems.

Responsibilities

• Lead and perform various coding quality reviews.
• Ensure compliance with national guidelines and company policies.
• Join special projects or reviews as needed.

Skills

Expert knowledge of medical coding

Inpatient coding experience

Attention to detail

Ability to meet productivity and accuracy targets

Education

Associate's or Bachelor's degree in HIM / HIT

RHIA or RHIT certification

Job description

Location: Nashville, TN REMOTE. Mid point salary $42.28 per hour

Job Type: Full-Time, Regular

Job Summary

Coding Quality Review Specialist. We're looking for a Coding Quality Review (CQR) Specialist to join our team! This is a remote / work-from-home position supporting our Coding Quality Review team. Your main role will be reviewing inpatient and outpatient medical coding to make sure it's accurate, consistent, and follows national and company guidelines.

What You'll Do

• Lead and perform various coding quality reviews (routine, pre-bill, policy-driven, incentive-based).
• Ensure coders follow national guidelines and company policies.
• Use your expert knowledge of medical coding.
• Join special projects or reviews as needed.
• Maintain 95%+ productivity and 95%+ accuracy.
• Stay up to date on industry standards and coding guidelines.
• Complete all required training and education.

Qualifications

• Education: Associate's or Bachelor's degree in HIM / HIT (preferred).
• Certifications: RHIA or RHIT required.
• Must be an Inpatient (IP) Coding Auditor for MS-DRG.
• Must have coding experience in all body systems (not just one specialty).
• Experience Required: 10+ years of hands-on medical coding experience.
• 3+ years of inpatient MS-DRG auditing in a hospital setting.
• Note: This role is not suitable for recent graduates —significant experience is essential.