Coding Quality Review Specialist at Purple Cow Recruiting

Nashville, Tennessee, United States -

Full Time

Start Date

Immediate

Expiry Date

10 Apr, 26

Salary

42.28

Posted On

10 Jan, 26

Experience

10 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Coding, Quality Review, Auditing, Inpatient Coding, Outpatient Coding, MS-DRG, Data Integrity, Compliance, Healthcare, Health Information Management, Productivity Standards, Accuracy Standards, Clinical Resources, Coding Guidelines, Policy Adherence, Expert-Level Knowledge

Industry

Staffing and Recruiting

Description

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.

Responsibilities

The Coding Quality Review Specialist will lead and perform quality reviews for inpatient and outpatient coding, ensuring compliance with coding guidelines and policies. This role requires maintaining high productivity and accuracy standards while conducting reviews across multiple Health Service Centers.