Job Description

Position Title: Coding Quality Review (CQR) Specialist

Location: Remote (U.S.-based only; Excludes CA, AK, NY, CO)

Position Type: Full-Time | Work From Home

Start Timeline: ASAP

Compensation

• Hourly Rate: Midpoint of $42.28/hr (based on experience)
• Employment Type: W2
• FTEs on Team: 4

About the Employer

A national leader in revenue cycle services, this organization supports over 650 hospitals and 2,400

physician practices. Their Coding Quality Review team ensures compliant, accurate coding that drives

reimbursement accuracy and healthcare data integrity across the enterprise.

Role Summary

The Coding Quality Review (CQR) Specialist is responsible for conducting high-quality audits of inpatient

and outpatient medical coding across multiple HIM Service Centers (HSCs). This fully remote role is

instrumental in maintaining adherence to national coding guidelines and company policies while

improving coder accuracy and reimbursement compliance.

Key Responsibilities

• Lead and perform internal coding quality reviews (routine, pre-bill, policy-driven, incentive-based)
• Audit inpatient MS-DRG medical records across all body systems
• Maintain coding accuracy (95% minimum) and productivity standards
• Participate in special audits and compliance projects
• Stay current on coding guidelines, data standards, and company policies
• Review and interpret multiple medical and regulatory resources for audit support
• Support coder education and development across HSCs

Must-Have Qualifications (Strict Requirements)

• RHIA, RHIT, or CCS certification (Required)
• 3+ years of hands-on MS-DRG inpatient coding audit experience (Required)
• Experience auditing across all body systems (No specialization-only coders)
• Minimum 10+ years of total coding experience in a hospital setting
• Must meet 95% accuracy and productivity benchmarks
• Proficiency in current coding guidelines and compliance tools
• Strong attention to detail and ability to work independently in a virtual environment

Note: Recent HIM grads and coders with no MS-DRG audit background will not be considered.

Preferred Qualifications

• Associates or Bachelors degree in Health Information Management (HIM) or Health
• Information Technology (HIT)
• Prior experience as a lead or educator in HIM coding QA/QC
• Familiarity with multi-facility audit processes or centralized coding platforms
• Experience participating in enterprise compliance audits or payer reviews

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