Posted 7 months ago
Coding Quality Review Specialist
AI Summary
CQR Specialist evaluates internal coding quality, audits inpatient/outpatient records for accuracy and compliance, and coaches coders to improve performance while ensuring adherence to standards and policies.
About this role
Cooperidge Consulting Firm is seeking a Coding Quality Review Specialist for a top ** healthcare** client based in ** Nashville, TN** (remote position).
The CQR Specialist performs internal quality assessments of coding accuracy and compliance across inpatient and outpatient records. This role ensures adherence to national coding standards, HSC policies, and company procedures to maintain optimal data integrity, accurate reimbursement, and compliance with federal regulations.
Job Responsibilities
- Perform internal quality reviews for inpatient and outpatient coding across multiple Health Information Management Service Centers (HSCs).
- Audit medical records to ensure coding accuracy, completeness, and compliance with MS-DRG and national standards.
- Provide feedback, coaching, and documentation support to coders to improve performance and maintain consistency.
- Participate in special review projects and policy-driven audit initiatives.
- Maintain productivity and accuracy rates of at least 95%.
- Keep coding knowledge current by reviewing official data quality standards, coding guidelines, and policy updates.
- Support adherence to internal and external compliance requirements for data and reimbursement accuracy.
Requirements
Education
- Associate’s or Bachelor’s Degree in Health Information Management (HIM) or Health Information Technology (HIT) preferred
Experience
- Minimum of 10 years of medical coding experience and at least 3 years of inpatient MS-DRG auditing in a hospital setting
- Prior experience with quality review and coding compliance required
Certifications/Licenses
- RHIA and/or RHIT certification required
- IP Coding Auditor certification for MS-DRG required
Skills or Competencies
- Expert knowledge of medical coding practices and standards
- Strong analytical and auditing skills
- Excellent written communication and attention to detail
- Proficiency with coding systems, data management tools, and remote audit platforms
Benefits
- Competitive pay with opportunities for overtime and weekend shifts.
- Comprehensive **medical, dental, and vision insurance **.
- Life insurance and ** disability coverage **.
- 401(k) retirement plan with employer match.
- Paid time off — vacation, sick leave, and holidays.
- Continuing education and professional development opportunities.
- Supportive, team-oriented work environment.
Skills
Explore related jobs
More jobs at Cooperidge Consulting Firm
- Revenue Operations & Growth Systems ArchitectPhilippines
- Revenue Operations & Growth Systems ArchitectUnited States
- Executive Assistant / Operations ManagerPhilippines
- Executive Assistant / Operations ManagerUnited States
- Outbound Sales Closer / Appointment SetterUnited States
- Outbound Sales Closer / Appointment SetterIndia
Similar Auditing Tools jobs
Jobs in Nashville
Neuro- Nurse PractitionerGuideStar Eldercare · Nashville, Tunisia- Licensed Practical NurseSono Bello · TN - Nashville
- Field Supervisor/Service ManagerGuild Garage Group · All 4 Seasons - Nashville, Tunisia
Field Supervisor/Service ManagerAll 4 Seasons Garage Doors · Nashville, Tunisia- Account ManagerEOS · Charlotte, North Carolina
Customer Service Representative - NashvilleHiller Plumbing, Heating, Cooling & Electrical · Nashville, Tunisia