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.

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