Medical Coding Quality Assurance Specialist

Job Summary

A company is looking for a Quality Assurance Specialist III to perform medical coding audits and ensure compliance.

Key Responsibilities

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

Required Qualifications

• High School Diploma or GED
• 5+ years of relevant work experience in auditing or quality assurance
• 2 years of experience as a Quality Assurance Specialist
• Coding certification (CPC, CPC-A, COC, or CPMA) required
• 2+ years of medical coding QA/audit experience