Full Description

We are looking for a detail-oriented Quality Control for Coding Specialist to ensure the accuracy, compliance, and consistency of medical coding and billing practices. This role plays a vital part in maintaining the integrity of health data and optimizing the revenue cycle by implementing internal audits, reviews, feedback processes, and continuous improvement initiatives. You’ll be part of a team committed to Leadership, Excellence, Innovation, and a culture of Agility, Accountability, Collaboration, and Customer Centricity. Key Responsibilities Delighting Our Customers & Stakeholders Ensure coding accuracy using ICD-10, CPT, and applicable guidelines Perform internal audits and peer reviews Validate clinical documentation supports coded entries Enforce compliance with HIPAA and payer requirements Growing Our Business Reduce coding-related denials and rejections Support revenue cycle optimization through timely audits Recommend process enhancements and tools for better accuracy Contribute insights to client engagement and support activities Improving the Way We Work Use audit tools and QC platforms to automate checks Maintain and update audit protocols and workflows Analyze data trends to address recurring issues Collaborate across departments for process alignment Developing Myself and Others Provide feedback and coaching to coding team members Lead or join training sessions on compliance and coding standards Stay updated on industry guidelines and certifications Promote a quality-first, learning-driven culture Key Metrics ≥ 95% coding accuracy rate ≥ 90% clean claims rate ≤ 5% documentation-related coding error rate ≥ 20% YOY reduction in coding-related denials ≥ 90% adherence to QC protocols and audit schedules ≥ 2 professional development activities per year Qualifications Degree in Health Information Management, Nursing, or related field Certified Professional Coder (CPC), CCS, or equivalent 2–3 years’ experience in medical coding and quality control Knowledge of ICD-10, CPT, HCPCS, CMS, and payer-specific guidelines Proficiency in medical coding software and audit platforms Strong analytical, communication, and collaboration skills Join us in redefining healthcare excellence—one accurate code at a time. Apply now and be part of a team committed to quality, innovation, and continuous improvement.