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Coding Quality Specialist

Centene • TX, US • published 2026-10-08 09:03:35.774352

Description

**Position Purpose:** The Coding Quality Coordinator II is the journey level position within a job series that performs complex reviews of clinical documentation on inpatient and outpatient medical records. Validates accuracy of diagnostic and procedural coding, payment methodology, and reimbursement amount; develops written rationale of findings; responds to providers for resolution of appeals. **Key Details:** Must be authorized to work in the U.S. without the need for employment\-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment\-based visa types H\-1B, L\-1, O\-1, H\-1B1, F\-1, J\-1, OPT, or CPT. * Performs complex review of physician clinical documentation on inpatient and outpatient medical records. * Performs quality analysis to determine accuracy of diagnostic and procedural coding, the correct interpretation and application of official coding guidelines and rules, and assignment of appropriate codes. * Determines correct payment methodology and reimbursement. * Develops case\-specific written rationale to substantiate and communicate findings to hospital, provider, medical director, ...

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