Coding Quality Reviewer (CQR) Specialist - Remote (Full Time, Direct Hire)

Job Title: Coding Quality Reviewer (CQR) Specialist
Location: Remote (Excluding: CA, AK, NY, CO)
Schedule: Full-Time • Work From Home
Compensation: Up to ~$42.28/hr (midpoint; experience-based)
Employment Type: Permanent, Full-Time

Job Summary

"Navitas Healthcare, LLC" is seeking a highly skilled Coding Quality Reviewer (CQR) Specialist to support enterprise-wide coding quality initiatives in a fully remote environment. This role performs comprehensive internal reviews of inpatient and outpatient coding across multiple service centers, ensuring full adherence to national coding guidelines and organizational policies.

The ideal candidate is an expert-level coding professional with deep MS-DRG auditing experience, broad multi-system coding proficiency, and a strong commitment to accuracy, compliance, and data integrity.

Responsibilities

• Lead and coordinate a wide range of coding quality reviews, including routine, pre-bill, policy-driven, and incentive-based assessments.

• Perform inpatient and outpatient coding audits across multiple service centers.

• Validate compliance with national coding guidelines, internal policies, and organizational standards.

• Apply expert-level knowledge of MS-DRG structures, sequencing rules, and clinical documentation interpretation.

• Support special audits, targeted reviews, and enterprise-level quality initiatives.

• Meet or exceed performance benchmarks:

  • 95%+ productivity

  • 95%+ accuracy

• Maintain current expertise through continuous review of official coding guidelines, clinical references, and internal quality standards.

• Provide mentorship and guidance to coding teams regarding compliance and best practices.

• Document audit findings clearly and accurately to support coder development and drive organizational improvement.

• Champion system-wide accuracy, compliance, and optimal reimbursement integrity.

Required Qualifications

• Undergraduate degree in HIM/HIT preferred (Associate or Bachelor’s).

• CCS, RHIA, or RHIT certification required.

• Trained and experienced MS-DRG Inpatient Coding Auditor.

• Minimum 3 years of inpatient MS-DRG auditing experience in a hospital setting.

• Minimum 10 years of total coding experience across all body systems.

• Hospital coding experience must include:

  • Inpatient

  • Outpatient

  • Audit

• Must be able to review all clinical service lines (no single-specialty coders).

• Must complete a mandatory 1-hour job shadow.

• Residency Exclusions: California, Alaska, New York, Colorado.

Benefits & Program Features

A competitive and comprehensive total rewards package supporting your health, financial security, well-being, and professional growth, including:

• Medical, prescription, dental, and vision insurance

• Behavioral health and telemedicine services

• Life and disability coverage

• Flexible Spending Accounts (FSA) and supplemental plans

• Employee assistance and wellness programs

• 401(k) with company match

• Employee Stock Purchase Plan

• Tuition reimbursement and certification support

• Paid time off, family leave, and a variety of leave programs

• Performance-based incentives and employee recognition programs

For more details contact at hdavda@navitashealth.com or Call / Text at 516-862-1169.

About Navitas Healthcare, LLC 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.