Coding Quality Review Specialist

Description

Heartline Staffing, Strategic Talent Partners with Purple Cow Recruiting, is seeking a Coding Quality Review (CQR) Specialist for a remote, work-from-home opportunity supporting Health Information Management Service Center (HSC) coding operations.

As a Coding Quality Review Specialist, you will perform internal quality assessment reviews on HSC coders to ensure compliance with national coding guidelines, HSC coding policies, and Company coding policies for complete, accurate, and consistent coding that supports appropriate reimbursement and data integrity. This role requires expert-level knowledge of inpatient and outpatient coding and the ability to conduct quality reviews across multiple HSCs while meeting strict productivity and accuracy standards.

Job Duties and 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

• Ensure coding staff adherence with national coding guidelines and internal policies

• Apply expert-level coding knowledge and demonstrate strong auditing judgment across all body systems

• Participate in special reviews or projects as assigned

• Maintain or exceed 95% productivity standards

• Maintain or exceed 95% accuracy standards

• Meet all educational requirements per current Company policy

• Review official data quality standards, coding guidelines, Company policies/procedures, and clinical/medical resources to ensure knowledge remains current

Compensation:

• Compensation: Midpoint $42.28/hour (based on years of experience)

Requirements

Education:

• Undergraduate degree in HIM/HIT preferred (Associate’s or Bachelor’s)

Certifications:

• RHIA and/or RHIT required

• IP Coding Auditor for MS-DRG required

Experience:

• Must have experience in ALL body systems (cannot be specialized in one area only)

• Must have 3 years of hands-on MS-DRG auditing in a hospital setting

• Cannot be a recent graduate; experience required (ideally 10+ years of overall coding experience and 3 years of auditing in MS-DRG inpatient medical records)

Work From Home State Restrictions:

• Candidates cannot reside in California, Alaska, New York, or Colorado

Assessment Requirement:

• Coding test required (90 minutes):

  – 20 Multiple Choice / True-False questions

  – 5–7 open-ended behavioral questions

Heartline Staffing is a Strategic Talent Partner with Purple Cow Recruiting. Applications are processed securely through Purple Cow Recruiting.