Coding Quality Specialist

Centene Corporation
Texas, United States
Full Time
Remote
Mid
USD 56,200 – 101,000
Associate Degree
Healthcare Healthcare Life Sciences

Posted 5 days ago

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Excellent 4.7

Job summary

The Coding Quality Coordinator II reviews clinical documentation for accuracy in inpatient and outpatient records, ensuring proper diagnosis and procedure coding, payment, and reimbursement. Responsibilities include conducting detailed reviews, developing rationales, responding to provider appeals, staying updated on coding guidelines, and participating in peer reviews, with a focus on healthcare documentation and coding accuracy.

Responsibilities

The Coding Quality Coordinator performs complex reviews of clinical documentation to validate the accuracy of diagnostic and procedural coding. They also determine appropriate payment methodologies and manage the resolution of provider appeals.

Qualifications

Billing and Reimbursement Clinical Documentation Improvement CPT coding Diagnosis Related Groups (DRG) HCPCS coding Healthcare Documentation ICD-10-CM ICD-9-CM Medical Coding Medical Record Review

The role requires at least two years of experience with DRG, ICD, and CPT coding systems. A professional certification such as RHIA, RHIT, CCS, CCA, or CPC is required, and an associate degree in Health Information Technology is preferred.

English

Benefits

  • Health insurance
  • 401k
  • Stock purchase plans
  • Tuition reimbursement
  • Paid time off
  • Holidays

Company

Centene Corporation

Centene Corporation

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Hospitals and Health Care
Location
Texas, United States

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Excellent 4.7
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