Coding Quality Review Specialist - CQR1219#TN01

NavitsPartners•Nashville, TN

1d•Remote

About The Position

Coding Quality Review Specialist (CQR) Location: Nashville, TN (Remote / Work From Home) Employment Type: Full-Time Why This Role Is a Great Opportunity Fully remote position with a stable, full-time schedule Work on high-impact quality initiatives across multiple hospital systems Competitive compensation based on experience Join a nationally recognized healthcare revenue cycle environment Role Overview Perform internal quality reviews for inpatient and outpatient coding teams Ensure accurate, compliant coding aligned with national guidelines and internal policies Support reimbursement integrity and clinical data accuracy across hospital settings

Requirements

Hospital coding experience is mandatory
Must have experience in inpatient, outpatient, and auditing
Minimum 3 years of hands-on MS-DRG inpatient auditing experience
Strong knowledge across all body systems (no single-specialty coders)
Associate’s or Bachelor’s degree in HIM/HIT preferred
One or more required certifications: CCS RHIA RHIT IP Coding Auditor experience for MS-DRG required
Physician-only coding experience will not be considered

Nice To Haves

Ideal candidates bring 10+ years of overall coding experience

Responsibilities

Conduct routine, pre-bill, policy-driven, and incentive-based quality audits
Review inpatient MS-DRG medical records across all body systems
Perform quality reviews for both inpatient and outpatient hospital coding
Ensure coder adherence to national coding standards and internal policies
Provide detailed audit feedback and education to improve coding accuracy
Participate in special audits, quality initiatives, and performance improvement projects
Maintain productivity standards of 95% or higher
Maintain accuracy standards of 95% or higher
Stay current with coding guidelines, data quality standards, and clinical references
Complete all required continuing education and training