Coding Quality Review Specialist - CQR1219#TN02 Job at NavitsPartners, Philadelphia, PA

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  • NavitsPartners
  • Philadelphia, PA

Job Description

Coding Quality Review Specialist (CQR)
Location:  Nashville, TN (Remote / Work From Home)
Employment Type:  Full-Time

Why This Role Is a Great Opportunity

  • Fully remote position with a stable, full-time schedule

  • Work on high-impact quality initiatives across multiple hospital systems

  • Competitive compensation based on experience

  • Join a nationally recognized healthcare revenue cycle environment

Role Overview

  • Perform internal quality reviews for inpatient and outpatient coding teams

  • Ensure accurate, compliant coding aligned with national guidelines and internal policies

  • Support reimbursement integrity and clinical data accuracy across hospital settings

Key Responsibilities

  • Conduct routine, pre-bill, policy-driven, and incentive-based quality audits

  • Review inpatient MS-DRG medical records across all body systems

  • Perform quality reviews for both inpatient and outpatient hospital coding

  • Ensure coder adherence to national coding standards and internal policies

  • Provide detailed audit feedback and education to improve coding accuracy

  • Participate in special audits, quality initiatives, and performance improvement projects

  • Maintain productivity standards of 95% or higher

  • Maintain accuracy standards of 95% or higher

  • Stay current with coding guidelines, data quality standards, and clinical references

  • Complete all required continuing education and training

Required Experience

  • Hospital coding experience is mandatory

  • Must have experience in  inpatient, outpatient, and auditing

  • Minimum 3 years of hands-on MS-DRG inpatient auditing experience

  • Strong knowledge across  all body systems (no single-specialty coders)

  • Ideal candidates bring 10+ years of overall coding experience

  • Recent graduates will not be considered

Education & Certifications

  • Associate’s or Bachelor’s degree in HIM/HIT preferred

  • One or more required certifications:

    • CCS

    • RHIA

    • RHIT

  • IP Coding Auditor experience for MS-DRG required

Additional Requirements

  • Physician-only coding experience will not be considered

  • Openings available: 4 FTEs

For more details reach at  sjackson@navitashealth.com .

About Navitas Healthcare, LLC:  It is a certified WBENC and one of the fastest-growing healthcare staffing firms in the US providing Medical, Clinical and Non-Clinical services to numerous hospitals. We offer the most competitive pay for every position we cater. We understand this is a partnership. You will not be blindsided and your salary will be discussed upfront.  

Job Tags

Full time, Remote work,

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