Quality Analyst - Certified Professional Coder

About the role

As a Quality Analyst, you will conduct continuous auditing, evaluation, and quality assurance of behavioral health medical charts, coding compliance, and billing accuracy. You will serve as a subject matter expert, ensuring the coding team maintains the highest levels of precision while adhering to strict HIPAA regulations and client-specific guidelines. The ideal candidate possesses exceptional deductive reasoning, a sharp eye for detail, and strong communication skills to provide constructive feedback and coaching to frontline coding teammates.

Responsibilities

• Conduct routine, objective quality reviews and audits of behavioral health coding, documentation, and billing submissions to ensure compliance with official coding guidelines.
• Identify trends, systemic issues, and individual coding errors using the AAPC CPT E/M MDM Leveling Grid/E/M Calculator to validate complex evaluation and management leveling.
• Deliver clear, actionable, and supportive feedback to coding teammates to improve accuracy and productivity.
• Partner with leadership (including coordination with stakeholders like Julienne Smith) to update auditing grids, identify training gaps, and streamline workflows.
• Safeguard patient data by ensuring all processed charts strictly adhere to HIPAA and internal security standards.
• Maintain effective working relations with external partners, clients, and internal stakeholders to support operational continuity, drive performance improvements, and achieve contractual quality goals.

Requirements

• Active CPC (Certified Professional Coder) credential required. Additional auditing credentials (e.g., CPMA) are a strong plus.
• Minimum 1 year of medical billing and coding experience, with at least 1 year specifically in a Quality Assurance, Auditing, or Senior Coder role.
• Hands-on experience with Behavioral Health/Mental Health coding and billing highly preferred.
• Expert-level mastery of CPT, ICD-10-CM, and E/M leveling tools.

Skills

• Exceptional deductive reasoning skills and an uncompromising attention to detail.
• Ability to clearly explain complex coding rationale and compliance rules to both technical peers and non-technical stakeholders.
• Excellent written and verbal communication; capable of coaching others constructively without sounding rigid.
• Curious, adaptable, organized, and highly efficient in a self-started, remote environment.