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Job Title: Coding Quality Review Specialist
Location: 100% Remote
Employment Type: Full-Time, Permanent

Job Summary

We are seeking an experienced Coding Quality Review (CQR) Specialist to join our Health Information Management Service Center (HSC) team. This fully remote role is responsible for performing internal quality assessment reviews of inpatient and outpatient coding to ensure compliance with national coding guidelines, HSC coding policies, and Company standards. The CQR Specialist plays a critical role in maintaining accurate, consistent coding that supports appropriate reimbursement and data integrity.

Job Responsibilities

• Lead, coordinate, and perform all quality review functions, including routine, pre-bill, policy-driven, and incentive plan-driven reviews

• Conduct inpatient and outpatient coding quality reviews across multiple Health Information Service Centers (HSCs)

• Assist in ensuring HSC coding staff adherence to national coding guidelines and Company policies

• Demonstrate and apply expert-level knowledge of medical coding practices and concepts

• Participate in special reviews, audits, and quality improvement projects as assigned

• Maintain or exceed 95% productivity standards

• Maintain or exceed 95% accuracy standards

• Meet all educational and compliance requirements as outlined in current Company policy

• Review and stay current on official data quality standards, coding guidelines, Company policies and procedures, and relevant clinical/medical resources

Qualifications

• Associate’s or Bachelor’s degree in Health Information Management (HIM) or Health Information Technology (HIT) preferred

• RHIA or RHIT certification required

• IP Coding Auditor experience for MS-DRG required

• Must have experience coding all body systems (no single-specialty focus)

• Minimum 3 years of hands-on MS-DRG inpatient coding audit experience in a hospital setting

• Not open to recent graduates

• Ideal candidate will have 10+ years of overall coding experience and at least 3 years of MS-DRG auditing experience
   

  Why Join Us

• 100% remote work environment

• Opportunity to work with experienced coding professionals across multiple facilities

• Make a direct impact on coding quality, compliance, and reimbursement accuracy
  Best regards,
  Maeve Phillips
  832-220-2041
  ✉️ maeve.phillips@patternshiring.com