Coding Quality Review Specialist (Remote)
Location: Remote (U.S.-based; exclusions apply)
Compensation: 35-55/hr
Employment Type: Full-Time, Work From Home
She Recruits is seeking an experienced Coding Quality Review Specialist to support a national Health Information Management team in conducting internal coding quality assessments across multiple facilities. This fully remote role requires a highly skilled coding auditor with extensive MS-DRG inpatient experience, strong critical thinking abilities, and deep familiarity with national coding guidelines. The ideal candidate is self-directed, accurate, and thrives in a productivity-driven virtual environment.
Role Overview:
The Coding Quality Review Specialist performs internal quality assessment reviews for inpatient and outpatient coding to ensure adherence to national coding standards, organizational policies, and data quality expectations. This specialist supports quality review processes, conducts routine and pre-bill audits, and contributes to special projects as assigned. The role requires maintaining high accuracy and productivity while staying up to date with all applicable coding regulations and clinical resources.
Key Responsibilities:
• Conduct routine, pre-bill, policy-driven, and incentive-based coding quality reviews across multiple facilities
• Ensure coding staff adherence to national guidelines, internal coding policies, and documentation requirements
• Apply expert-level knowledge of inpatient and outpatient coding, including MS-DRG auditing
• Maintain or exceed productivity benchmarks (95%+) and accuracy standards (95%+)
• Review data quality standards, coding guidelines, policies, and clinical resources to maintain current knowledge
• Participate in special projects or reviews as assigned
• Support CQR team tools, systems, and workflows in a remote environment
• Meet all educational and ongoing training requirements
• Complete required coding assessments during the hiring process (multiple choice, true/false, behavioral questions)
Qualifications:
• Associate’s or Bachelor’s degree in HIM/HIT preferred
• RHIA or RHIT required
• Must be an IP Coding Auditor for MS-DRG
• Minimum 3 years of hands-on MS-DRG inpatient hospital coding auditing experience required
• Must have experience coding all body systems (cannot be specialized in one area)
• Ideal candidate has 10+ years of total coding experience
• Must have strong technical proficiency and the ability to work independently in a remote environment
• Cannot reside in: California, Alaska, New York, or Colorado
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