Facility Coding Quality Specialist

Job Description

• This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Facility Coding Quality Specialist based in United States. This role plays a critical part in ensuring the accuracy, compliance, and quality of medical coding across inpatient and outpatient facility settings. You will perform detailed retrospective reviews of clinical documentation and coded data to identify errors, inconsistencies, and opportunities for improvement. Working in a highly regulated healthcare environment, you will help ensure adherence to coding standards, reimbursement guidelines, and payer requirements while safeguarding data integrity and compliance. The position also involves close collaboration with internal coding teams, providing feedback, training support, and second-level review expertise. You will act as both a quality gatekeeper and a technical advisor, helping strengthen overall coding accuracy and financial performance. This is a fully remote role suited for detail-oriented professionals who thrive in analytical, compliance-driven healthcare operations.
• Accountabilities: In this role, you will be responsible for ensuring coding accuracy, compliance, and continuous quality improvement across facility inpatient and outpatient coding operations. Perform detailed retrospective reviews of medical records to identify coding, billing, and documentation errors in alignment with AHA, CMS, AMA, and CPT guidelines. Conduct second-level coding reviews to validate diagnosis and procedure code accuracy and ensure compliance with reimbursement regulations. Analyze audit results to identify root causes of coding errors and support corrective action plans. Provide guidance, feedback, and education to internal coding staff on compliance, documentation, and payer requirements. Respond to coding-related inquiries, denials, and compliance questions with research-based resolutions. Monitor coder performance and maintain quality assurance benchmarks, including accuracy and review targets. Support the development of improved coding processes, tools, and training initiatives to enhance productivity and accuracy. Prepare reports, deliverables, and status updates for leadership and participate in training and quality meetings. Ensure adherence to ethical coding standards, privacy regulations, and organizational compliance policies. Requirements: This position requires strong facility coding expertise, deep knowledge of coding guidelines, and the ability to work independently in a quality-focused healthcare environment. 2–3+ years of inpatient and outpatient facility coding and/or auditing experience. Active coding certification (AHIMA or AAPC required; CCS, CPC, RHIA, or RHIT strongly preferred). Strong knowledge of ICD-10-CM/PCS, CPT, HCPCS, and APC reimbursement methodologies. Experience working with EMR systems and reviewing both electronic and handwritten medical records. Solid understanding of coding compliance, documentation standards, and payer requirements. Strong analytical and problem-solving skills with attention to detail and accuracy. Excellent written and verbal communication skills, with the ability to educate and collaborate effectively. Ability to manage multiple priorities, meet deadlines, and work independently in a remote environment. Proficiency in Microsoft Office tools, particularly Excel and Word. Benefits: Fully remote position within the United States Competitive compensation aligned with experience and certifications Health, dental, and vision insurance coverage Paid time off, holidays, and flexible work arrangements Retirement savings plan options (where applicable) Professional development and continuing education support Opportunity to work within a specialized clinical and revenue cycle environment Collaborative, quality-driven culture focused on learning and improvement
• How Jobgether works: We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team. We appreciate your interest and wish you the best! Why Apply Through Jobgether? Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time. #LI-CL1
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