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.

Responsibilities

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; 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; 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; 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

Requirements

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