Request, process, review, and validate medical records to ensure compliance with national quality measures and the accuracy of claims data. Apply technical expertise to abstract information and accurately enter it into specialized databases.

Obtain, process, and maintain medical records for audits and quality improvement (QI) reviews while safeguarding the confidentiality of protected health information (PHI). Respond to inquiries via phone, email, and fax related to health record reviews, reimbursement, and general information. Perform filing, scanning, and purging of health records as needed.

Track data submissions and prepare correspondence and documentation to support follow-up actions related to QI findings, corrective action plans, audits, and other identified areas. Review materials for accuracy, including data integrity, spelling, grammar, formatting, and completeness.

Assist the Medical Record Review (MRR) Lead in developing timelines, preparing summaries, and updating project protocols, policies, and procedures related to MRR activities.

Perform other duties as assigned.

High school diploma or equivalent and a minimum of three years of professional medical coding experience required. Relevant college coursework or vocational/technical training may substitute at an equivalent rate for the required experience.

Certification as a Certified Professional Coder (CPC) through the American Academy of Professional Coders (AAPC), or one of the following credentials, is required: Certified Coding Specialist (CCS-P)/Certified Coding Assistant (CCA)/Registered Health Information Administrator (RHIA), or an equivalent certification.

An AA, AS or AAS degree is preferred, along with general computer proficiency, including accurate data entry and competence with Microsoft Word and Excel. Strong communication and telephone skills are essential. The individual must be able to handle confidential materials in compliance with HIPAA regulations.