Certified Coding Quality Specialist

Job Summary

Conducting coding quality reviews remotely, the full-time Certified Coding Quality Specialist will ensure accurate assignment of ICD-10-CM codes based on clinical documentation and provide education to coders while maintaining compliance with regulations.

Key responsibilities

• Perform coding quality reviews of medical records to verify accurate ICD-10-CM code assignment
• Provide formal reports on audit findings and conduct education for internal and external coders
• Maintain knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations

Required qualifications

• Minimum of 5 years certified with a core coding credential from AHIMA or AAPC (CCS, CCS-P, CPC, CRC)
• At least 3 recent years of production coding experience in Retrospective Risk Adjustment coding
• A minimum of 2 years conducting coder audits in the Risk Adjustment environment
• Experience with Medicaid coding, including at least 1 year of Complete Code Capture coding
• Ability to pass a coding quiz with 80% accuracy and maintain a minimum 95% accuracy on audits