Virginia Licensed Coding Quality Specialist

Job Summary

To support a specialized Physical Medicine & Rehabilitation practice, the fully remote Virginia Licensed Coding Quality Specialist will conduct coding quality reviews, validate coding accuracy, and enhance provider education 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, modifier usage, and medical necessity requirements to ensure accurate coding
• Identify documentation inconsistencies and facilitate clear communication with providers to enhance coding quality and compliance

Required qualifications

• High School Diploma or GED required
• 5+ years of relevant coding experience, with a preference for experience in Hospital Rehabilitation and Wound Care coding
• Certified Professional Coder (CPC) certification required
• Expertise in coding, auditing, and clinical documentation review
• Strong understanding of payer-specific guidelines and coding compliance standards