Medical Coding QA Specialist

Job Summary

A company is looking for a Medical Coding QA Specialist to perform prepayment reviews of medical records and claims.

Key Responsibilities

• Conduct in-depth prepayment medical record audits for accuracy and compliance
• Review claims from high volume providers and validate benefit payments
• Document audit findings and provide coaching and feedback to internal teams

Required Qualifications

• High School Diploma or GED
• 5+ years of relevant experience in Auditing, Quality Assurance, or comparable fields
• 2 years of experience as a Quality Assurance Specialist
• Coding certification (CPC, CPC-A, COC, or CPMA) required
• Proficient in Microsoft Office programs and Excel