Coding Quality Review Specialist CQRS 25-34030

Job Title: Coding Quality Review Specialist
Location: Remote / Work From Home Nashville Tennessee
Job Type: Permanent / Full-Time

Schedule

• 40 Hours per Week
• Flexible Day or Night Shift Availability Required

Compensation

• Pay Rate: Approximately $42.28/hour
  Compensation based on experience.

Position Overview

A healthcare services organization is seeking an experienced Coding Quality Review Specialist to support remote Health Information Management operations. This role is responsible for performing internal quality assessment reviews for inpatient and outpatient coding to ensure compliance with national coding standards organizational policies reimbursement accuracy and data integrity.

The ideal candidate will possess advanced coding audit expertise strong MS-DRG auditing experience and comprehensive knowledge across multiple medical specialties and body systems.

Key Responsibilities

• Perform internal coding quality reviews for inpatient and outpatient medical records
• Ensure compliance with national coding guidelines and organizational coding policies
• Conduct routine pre-bill policy-driven and incentive-driven coding reviews
• Evaluate coding accuracy completeness and reimbursement integrity
• Support coding staff adherence to coding standards and quality expectations
• Participate in special projects audits and process improvement initiatives
• Maintain productivity and accuracy standards of 95% or greater
• Provide feedback and education to coding professionals as needed
• Demonstrate expert-level knowledge of medical coding and MS-DRG auditing practices

Qualifications

• Undergraduate degree in HIM/HIT preferred (Associates or Bachelors degree)
• CCS RHIA or RHIT certification required
• IP Coding Auditor experience for MS-DRG required
• Minimum 3 years of hands-on MS-DRG auditing experience in a hospital setting required
• Extensive coding experience preferred ideally 10 years in inpatient coding and auditing
• Experience across all body systems required; specialty-only coding backgrounds will not be considered
• Physician coding experience alone will not qualify
• Mandatory 1-hour job shadow required during hiring process

Skills & Experience

• Strong understanding of inpatient coding guidelines and reimbursement methodologies
• Excellent analytical auditing and documentation review skills
• Ability to work independently in a remote environment
• Strong communication and collaboration skills
• High attention to detail and commitment to coding accuracy

Additional Information

• Remote position; candidates residing in California Alaska New York or Colorado are not eligible for employment in this role

For more details reach at or Call / Text at .

About Navitas Healthcare LLC: It is a certified WBENC and one of the fastest-growing healthcare staffing firms in the US providing Medical Clinical and Non-Clinical services to numerous hospitals. We offer the most competitive pay for every position we cater. We understand this is a partnership. You will not be blindsided and your salary will be discussed upfront.