Maryland Licensed Coding Reviewer

Job Summary

To support healthcare data accuracy, the part-time Maryland Licensed Coding Reviewer will conduct clinical documentation reviews, perform compliance audits, and generate detailed reports while working remotely.

Key responsibilities

• Performing audit functions for the HSCRC Inpatient/Outpatient Data Abstract Review Contract in a timely and accurate manner
• Generating well-written deliverables and audit work papers while providing feedback to hospitals regarding audit findings
• Interpreting and applying coverage and payment policies, ensuring compliance with regulations and standards

Required qualifications

• 5 years of relevant experience in complex coding, quality assurance, training, appeals, or auditing services involving ICD-10-CM/PCS, CPT/HCPCS, and DRG/APRDRG
• Bachelor's degree in a related discipline or specialized licensure, certification, or accreditation (e.g., RHIA, RHIT, RN, MD, CCS, CCS-P, CPC, CRC)
• Practical knowledge of HIPAA and regulations pertaining to confidentiality and privacy of protected health information
• Ability to effectively communicate with other reviewers and clients to ensure quality audit findings
• Experience in researching and applying solutions related to coding and auditing processes