Analysis Skills, Auditing, Certified Coding Specialist (CCS), Clinical Medicine, Code Reviews, Coding Standards, Communication Skills, Data Quality, Detail Oriented, Diagnosis-Related Group (DRG), Documentation Review, Health Information Management, Healthcare, Hospital, Maintain Compliance, Medical Coding, Medical Records, Outpatient Care, Patient Care, Process Improvement, Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Reimbursement, Reimbursement Guidelines, Team Player, Work From Home
LOCATION
Nashville, TN
POSTED
Today
Job Title: Coding Quality Review Specialist Location: Remote / Work From Home – Nashville, Tennessee Job Type: Permanent / Full-Time
Schedule
40 Hours per Week
Flexible Day or Night Shift Availability Required
Compensation
Pay Rate: Approximately $42.28/hour Compensation based on experience.
Position Overview
A healthcare services organization is seeking an experienced Coding Quality Review Specialist to support remote Health Information Management operations. This role is responsible for performing internal quality assessment reviews for inpatient and outpatient coding to ensure compliance with national coding standards, organizational policies, reimbursement accuracy, and data integrity.
The ideal candidate will possess advanced coding audit expertise, strong MS-DRG auditing experience, and comprehensive knowledge across multiple medical specialties and body systems.
Key Responsibilities
Perform internal coding quality reviews for inpatient and outpatient medical records
Ensure compliance with national coding guidelines and organizational coding policies
Conduct routine, pre-bill, policy-driven, and incentive-driven coding reviews
Evaluate coding accuracy, completeness, and reimbursement integrity
Support coding staff adherence to coding standards and quality expectations
Participate in special projects, audits, and process improvement initiatives
Maintain productivity and accuracy standards of 95% or greater
Provide feedback and education to coding professionals as needed
Demonstrate expert-level knowledge of medical coding and MS-DRG auditing practices
Qualifications
Undergraduate degree in HIM/HIT preferred (Associate’s or Bachelor’s degree)
CCS, RHIA, or RHIT certification required
IP Coding Auditor experience for MS-DRG required
Minimum 3 years of hands-on MS-DRG auditing experience in a hospital setting required
Extensive coding experience preferred, ideally 10+ years in inpatient coding and auditing
Experience across all body systems required; specialty-only coding backgrounds will not be considered
Physician coding experience alone will not qualify
Mandatory 1-hour job shadow required during hiring process
Skills & Experience
Strong understanding of inpatient coding guidelines and reimbursement methodologies
Excellent analytical, auditing, and documentation review skills
Ability to work independently in a remote environment
Strong communication and collaboration skills
High attention to detail and commitment to coding accuracy
Additional Information
Remote position; candidates residing in California, Alaska, New York, or Colorado are not eligible for employment in this role
For more details reach at Aditi.sharma@navitashealth.com or Call / Text at 516-587-6677.
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.