Home Health Medical Coding QA Specialist

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.