Coding Quality Specialist

This is a fully remote position, open to applicants in Massachusetts.

📋 Description

• Oversee, evaluate, and enhance the quality of coding processes, documentation, and compliance with coding standards and regulations.

• Design and execute coding quality assurance initiatives, assessing the accuracy, completeness, and compliance of medical coding practices.

• Ensure that coding practices conform to official coding standards, guidelines, and regulatory requirements established by the AMA, CMS, and other pertinent organizations.

• Review medical records, physician notes, and additional documentation to evaluate the adequacy and specificity of the codes assigned.

• Create and provide coding education and training programs for coders, physicians, and healthcare professionals.

• Identify opportunities to optimize coding workflows, improve efficiency, and enhance coding accuracy.

• Establish quality metrics and reporting systems to track coding accuracy, productivity, and compliance.

• Collaborate and communicate with healthcare providers, coders, billing personnel, and stakeholders to address questions, clarify documentation needs, and resolve coding issues.

⛳️ Requirements

• An Associate's Degree in Medical Billing and Coding is mandatory.

• A minimum of 5 years of experience in Medical Coding is required.

• At least 1 year of Quality Assurance experience is preferred.

• Advanced knowledge of medical coding systems, including ICD-10-CM and ICD-10-PCS, and their application in hospital billing.

• Familiarity with coding guidelines and regulations as stipulated by the AMA, CMS, and other relevant entities.

• Exceptional analytical skills and meticulous attention to detail for accurate interpretation of medical documentation and code assignment.

• Strong understanding of anatomy, physiology, medical terminology, and disease processes.

• Excellent written and verbal communication abilities.

• Capacity to work independently, prioritize tasks, and meet deadlines within a fast-paced setting.

• Availability to work Monday to Friday during Eastern Standard business hours.

• Capability to maintain a quiet, secure, HIPAA-compliant workstation.

🏝️ Benefits

• Comprehensive benefits package.

• Opportunities for career advancement.

• Differentials.

• Premiums.

• Applicable bonuses.

• Recognition programs.

• Support for professional growth.

• Reasonable accommodations for applicants with disabilities.