Coding Quality Review Specialist - CQRS 25-34030

Job Title: Coding Quality Review Specialist

Location: Remote (Work From Home – Nashville, TN)

Employment Type: Permanent / Full-Time

Schedule:

• 40 hours per week
• Flexible availability required (Day or Night Shift)

Job Overview:

We are seeking an experienced Coding Quality Review Specialist to support remote Health Information Management (HIM) operations. This role is responsible for conducting internal quality audits of inpatient and outpatient coding to ensure compliance with industry standards, accuracy in reimbursement, and overall data integrity.

The ideal candidate will have strong expertise in MS-DRG auditing, along with extensive experience across multiple medical specialties and coding environments.

Key Responsibilities:

• Perform internal coding quality audits for inpatient and outpatient medical records
• Ensure compliance with national coding guidelines and internal policies
• Conduct pre-bill, routine, and targeted coding reviews
• Evaluate coding accuracy, completeness, and reimbursement integrity
• Support and reinforce coding quality standards and best practices
• Participate in audits, special projects, and process improvement initiatives
• Maintain productivity and accuracy standards (95% or higher)
• Provide feedback, education, and guidance to coding staff
• Apply expert-level knowledge of MS-DRG auditing and coding practices

Required Qualifications:

• CCS, RHIA, or RHIT certification required
• Minimum 3+ years of MS-DRG auditing experience in a hospital setting
• Extensive experience in inpatient coding and auditing (10+ years preferred)
• Experience across multiple body systems (generalist coding background required)
• Strong knowledge of coding guidelines and reimbursement methodologies
• Prior experience as an IP Coding Auditor

Education:

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

Skills & Competencies:

• Strong analytical and auditing skills
• High attention to detail and accuracy
• Ability to work independently in a remote environment
• Excellent communication and collaboration skills
• Strong documentation review and compliance knowledge

Work Environment:

• Independent, productivity-driven role
• Quality-focused healthcare operations environment

For more details reach at

https://Aditi.sharma@navitashealth.com/

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.