Virginia Licensed Coding Quality Specialist

Job Summary

To support specialized Physical Medicine & Rehabilitation services, the fully remote Virginia Licensed Coding Quality Specialist will leverage expertise in coding and auditing to ensure accurate documentation and compliance while focusing on Encompass Hospital Rehabilitation and Wound Care coding.

Key responsibilities:

• Perform detailed coding quality reviews and audits for PM&R Musculoskeletal services, including Encompass Hospital Rehabilitation and Wound Care coding
• Apply expert knowledge of CPT, ICD-10-CM, and payer-specific guidelines to validate coding accuracy and ensure compliance
• Identify documentation inconsistencies and facilitate communication for provider clarification to enhance coding quality and accuracy

Required qualifications:

• High School Diploma or GED required
• 5+ years of relevant coding experience, with a preference for Hospital Rehabilitation and Wound Care coding
• Certified Professional Coder (CPC) certification required
• Strong knowledge of coding practices for musculoskeletal services and pain management procedures
• Experience in clinical documentation review and provider education within a healthcare setting