Coding Quality Review Specialist

Cooperidge Consulting Firm is seeking a Coding Quality Review Specialist for a top healthcare client based in Nashville, TN (remote position).

The CQR Specialist performs internal quality assessments of coding accuracy and compliance across inpatient and outpatient records. This role ensures adherence to national coding standards, HSC policies, and company procedures to maintain optimal data integrity, accurate reimbursement, and compliance with federal regulations.

Job Responsibilities

• Perform internal quality reviews for inpatient and outpatient coding across multiple Health Information Management Service Centers (HSCs).
• Audit medical records to ensure coding accuracy, completeness, and compliance with MS-DRG and national standards.
• Provide feedback, coaching, and documentation support to coders to improve performance and maintain consistency.
• Participate in special review projects and policy-driven audit initiatives.
• Maintain productivity and accuracy rates of at least 95%.
• Keep coding knowledge current by reviewing official data quality standards, coding guidelines, and policy updates.
• Support adherence to internal and external compliance requirements for data and reimbursement accuracy.

Education

• Associate’s or Bachelor’s Degree in Health Information Management (HIM) or Health Information Technology (HIT) preferred

Experience

• Minimum of 10 years of medical coding experience and at least 3 years of inpatient MS-DRG auditing in a hospital setting
• Prior experience with quality review and coding compliance required

Certifications/Licenses

• RHIA and/or RHIT certification required
• IP Coding Auditor certification for MS-DRG required

Skills or Competencies

• Expert knowledge of medical coding practices and standards
• Strong analytical and auditing skills
• Excellent written communication and attention to detail
• Proficiency with coding systems, data management tools, and remote audit platforms