Perform comprehensive internal quality reviews of inpatient and outpatient medical coding across multiple Health Information Management Service Centers. This role focuses on verifying coding accuracy, completeness, and compliance with MS-DRG classifications and national regulatory standards.
Key Responsibilities
- Conduct regular audits of medical records to validate correct code assignment and alignment with official guidelines
- Deliver targeted feedback and coaching to coding professionals to enhance performance and consistency
- Support documentation improvement initiatives to strengthen data quality and reimbursement integrity
- Participate in policy-driven audit projects and special review assignments as needed
- Maintain a minimum 95% accuracy rate while meeting established productivity benchmarks
- Stay current with evolving coding standards, compliance requirements, and data quality protocols
- Ensure all coding practices align with federal regulations, HSC policies, and organizational procedures
Qualifications
Candidates must have experience conducting internal coding audits and ensuring compliance with national coding frameworks. Demonstrated ability to uphold 95% accuracy and productivity standards is essential. A strong understanding of healthcare data integrity, reimbursement principles, and regulatory compliance is required to support ongoing quality assurance efforts.
