High school diploma or equivalent and 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.

The Institute for Child Health Policy (ICHP) at the University of Florida supports contracts with Texas and Florida Medicaid agencies and conducts policy research utilizing these and other health data resources. ICHP is seeking a highly motivated professional to conduct medical record review activities for the Texas External Quality Review Organization (EQRO), a large-scale, state-wide initiative supporting the Texas Medicaid and CHIP programs. This position plays an important role in ensuring accuracy and integrity of medical records reviews, which directly inform statewide quality improvement efforts. Serving as a member of the Quality Improvement Team, this position will be responsible for managing complex medical record review processes, overseeing and maintaining an Access database to support these activities, contributing to audit and compliance efforts, and helping advance the Institute’s mission of improving health outcomes through research and policy innovation.

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.

Maintains and updates quality improvement (QI) databases, generates reports, and assists with the interpretation of results. Ensures accurate data entry across QI medical record review (MRR) deliverables and provides technical and clerical support to MRR lead and QI staff. Accurately documents data from QI deliverables, noting areas of concern. Prepares meeting materials, records, and transcribes minutes for meetings, reviews, and audits. Supports literature reviews and contributes to QI team deliverables as needed.

Obtain, process, and maintain medical records for audits and 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 MRR Lead in developing timelines, preparing summaries, and updating project protocols, policies, and procedures related to MRR activities.

Perform other duties as assigned.

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