Remote Quality Improvement & Coding Analyst

Highmark Health; United States; Remote; USD 63,000 - 97,000; Full time

Benefits offered by this job

Remote work

Job summary

Highmark Health is seeking a quality and coding professional to collaborate with compliance, process improvement, and medical record review teams across product lines. You will drive ICD-10-CM coding accuracy, enhance documentation quality, and support STARS and HEDIS initiatives.

The role requires RN/LPN licensure or a healthcare-related bachelor’s, 3 years of healthcare experience, and relevant certifications or progress toward them.

Qualifications

• Bachelor’s degree in a healthcare-related field is required.
• RN or LPN license is required or multi-state licensure via eNLC.
• 3 years of nursing or healthcare-related field experience.
• CPC, CRC, RHIA, RHIT, or CCS certification or within 4 months of hire.

Responsibilities

• Develop and manage process improvement initiatives with data analysis, process analysis, and report generation.
• Review medical records to ensure proper ICD-10-CM coding and documentation.
• Educate providers and staff on coding, documentation, and quality measures such as STARS and HEDIS.
• Conduct audits and re-audits; communicate results and drive corrective actions.

Education

Bachelor’s degree in a Healthcare-related field

RN or LPN license

Tools

Microsoft Office

Job description

Highmark Health is seeking a quality and coding professional to collaborate with compliance, process improvement, and medical record review teams across product lines. You will drive ICD-10-CM coding accuracy, enhance documentation quality, and support STARS and HEDIS initiatives.

The role requires RN/LPN licensure or a healthcare-related bachelor’s, 3 years of healthcare experience, and relevant certifications or progress toward them.