Coding Quality Review Specialist

Coding Quality Review Specialist - Nashville, TN

Full-time • Work From Home

Job Summary  

As a Coding Quality Review (CQR) Specialist, you will operate in a work from home environment supporting all CQR team related systems and tools. You will perform internal quality assessment reviews on Health Information Management Service Center(HSC) coders to ensure compliance with national coding guidelines, the HSC coding policies and the Company coding policies for complete, accurate and consistent coding which result in appropriate reimbursement and data integrity. 

Job Responsibilities

• Lead, coordinate and perform all functions of quality reviews (routine, pre-bill, policy driven and incentive plan driven)for inpatient and outpatient coding across multiple HSCs
• Assist in ensuring HSC coding staff adherence with coding guidelines and policy
• Demonstrate and apply expert level knowledge of medical coding practices and concepts
• Participate on special reviews or projects
• Maintain or exceed 95% productivity standards
• Maintain or exceed 95% accuracy
• Meet all educational requirements as stated in current Company policy
• Review all official data quality standards, coding guidelines, Company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain current

Qualifications

• Undergraduate degree in HIM/HIT preferred (Associate's or Bachelor's)
• RHIA, RHIT and/or mandatory
• IP Coding Auditor for MS-DRG
• Must have experience in all body systems – cannot be specialized in one area i.e., Orthopedic etc.
• Must have 3 years of hands on coding MS-DRG auditing in a hospital setting.
• Seeking someone with experience ideally 10+ years of coding and 3 years of auditing in MS-DRG Inpatient medical records.

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