Coding Quality Review Specialist

Purple Cow Recruiting • Nashville, TN

1d • Remote

About The Position

Heartline Staffing, Strategic Talent Partners with Purple Cow Recruiting, is seeking a Coding Quality Review (CQR) Specialist for a remote, work-from-home opportunity supporting Health Information Management Service Center (HSC) coding operations.

As a Coding Quality Review Specialist, you will perform internal quality assessment reviews on HSC coders to ensure compliance with national coding guidelines, HSC coding policies, and Company coding policies for complete, accurate, and consistent coding that supports appropriate reimbursement and data integrity. This role requires expert-level knowledge of inpatient and outpatient coding and the ability to conduct quality reviews across multiple HSCs while meeting strict productivity and accuracy standards.

Requirements

• Undergraduate degree in HIM/HIT preferred (Associate’s or Bachelor’s)
• RHIA and/or RHIT required
• IP Coding Auditor for MS-DRG required
• Must have experience in ALL body systems (cannot be specialized in one area only)
• Must have 3 years of hands-on MS-DRG auditing in a hospital setting
• Cannot be a recent graduate; experience required (ideally 10+ years of overall coding experience and 3 years of auditing in MS-DRG inpatient medical records)
• Candidates cannot reside in California, Alaska, New York, or Colorado
• Coding test required (90 minutes): – 20 Multiple Choice / True-False questions – 5–7 open-ended behavioral questions

Responsibilities

• Lead, coordinate, and perform all functions of quality reviews (routine, pre-bill, policy-driven, and incentive-plan-driven) for inpatient and outpatient coding across multiple HSCs
• Ensure coding staff adherence with national coding guidelines and internal policies
• Apply expert-level coding knowledge and demonstrate strong auditing judgment across all body systems
• Participate in special reviews or projects as assigned
• Maintain or exceed 95% productivity standards
• Maintain or exceed 95% accuracy standards
• Meet all educational requirements per current Company policy
• Review official data quality standards, coding guidelines, Company policies/procedures, and clinical/medical resources to ensure knowledge remains current

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree