Inpatient 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 to assess the accuracy, completeness, and adherence to medical coding practices.

• Ensure that coding practices are in accordance with official coding conventions, guidelines, and regulatory standards from organizations such as AMA and CMS.

• Review medical records, physician notes, and other documents to evaluate the adequacy and specificity supporting assigned codes.

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

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

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

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

⛳️ Requirements

• 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 experience in quality assurance is preferred.

• Extensive inpatient coding experience is essential; experience in an academic facility is preferred.

• Experience with ICD-10-PCS coding is required.

• In-depth knowledge of ICD-10, CPT, and HCPCS coding systems is necessary.

• Familiarity with coding guidelines and regulations, including those set by AMA and CMS, is essential.

• Strong analytical skills coupled with attention to detail are required.

• A solid understanding of anatomy, physiology, medical terminology, and disease processes is necessary.

• Excellent written and verbal communication abilities are essential.

• Capability to work independently, manage priorities, and meet deadlines in a dynamic environment is required.

🏝️ Benefits

• Comprehensive benefits package.

• Opportunities for career advancement.

• Differentials offered.

• Premiums available.

• Applicable bonuses.

• Recognition programs in place.

• Support for professional growth.

• Reasonable accommodations provided during the application, interview, and employment process.