Coding Quality Reviewer Specialist

Full-Time • 100% Remote / Work From Home

Candidates residing in California, Alaska, New York, or Colorado cannot be considered for work from home opportunities

$40 to $50 per hour depending on experience

Position Overview

This is a full-time work-from-home role supporting a national team of coding professionals. As a Coding Quality Review (CQR) Specialist, you will conduct internal quality assessments to ensure coders meet national standards and adhere to established coding guidelines. Your work will directly support data integrity and appropriate reimbursement across multiple healthcare facilities.

Key Responsibilities

• Lead, coordinate, and perform quality reviews (routine, pre-bill, policy-driven, and incentive-based) for both inpatient and outpatient coding
• Support and guide coding staff to ensure adherence to official coding guidelines and policies
• Apply expert-level knowledge of medical coding practices and concepts
• Participate in special reviews and projects as assigned
• Maintain minimum 95% productivity standards
• Achieve and maintain minimum 95% coding accuracy
• Meet all ongoing educational requirements
• Review current data quality standards, coding guidelines, policies, procedures, and clinical resources to ensure coding knowledge remains up to date

Qualifications

• Undergraduate degree in HIM/HIT preferred (Associate's or Bachelor's)
• CCS, RHIA, RHIT required
• IP Coding Auditor for MS-DRG required
• Must have experience across all body systems — not specialized in one area
• Minimum 3 years of hands-on MS-DRG auditing in a hospital setting
• Ideally 10+ years of coding experience
• Cannot be a recent graduate — prior real-world coding & auditing experience is required