Coding Quality Assurance Specialist

Job Summary

To support the Risk Adjustment Coding Team, the part-time QA I Coding Operations Specialist will monitor and report on coding accuracy, provide coaching and feedback to coders, and conduct audits to ensure compliance with quality standards.

Key responsibilities

• Provides Quality Assurance feedback and reviews coding work to ensure quality standards are met
• Completes chart reviews for proper HCC-mapped diagnosis coding and ensures adherence to coding guidelines
• Communicates findings and trends to staff and recommends additional training based on quality audit results

Required qualifications

• High School diploma required; Bachelor's degree preferred
• Coding certification required through AAPC or AHIMA (CPC, CRC, CCS, etc.)
• Minimum of one to three years of HCC coding experience
• Expertise in medical record auditing, particularly in HCC mapped diagnosis coding
• Demonstrated high performance in meeting production and quality goals