Quality Analyst – Outpatient, Healthcare

This is a fully remote position, open to applicants in United States.

📋 Description

• Analyze coding audits to verify that findings are precise, uniform, and adhere to compliance standards.

• Offer guidance and support to coders to boost their accuracy and self-assurance.

• Share insights from audit evaluations and pinpoint training requirements or process deficiencies.

• Participate in enhancing audit techniques, procedures, and documentation.

• Work closely with colleagues and leadership to promote quality enhancements.

• Provide detailed root cause analyses for coding inconsistencies.

• Ensure adherence to company policies and regulatory requirements.

• Accept additional responsibilities and challenges as necessary in a fast-paced environment.

⛳️ Requirements

• High School Diploma (mandatory); CCS or CPC certification (mandatory)

• Minimum of 5 years of coding experience in both professional and hospital environments

• Extensive knowledge of ICD-10, HCPCS/CPT, Medicare OPPS, and APCs

• Proficient in utilizing encoder tools (Optum, TrueCode, 3M, Webstrat)

• Familiarity with Medicare LCD and NCD guidelines

• Capable of coding intricate outpatient services (e.g., interventional radiology, ambulatory surgery, ER, observation)

• Proficient in applying modifiers and adhering to Medicare/NCCI regulations

• Strong documentation capabilities with the competence to reference official coding standards

• Exceptional communication, organizational, and problem-solving skills

• Able to work independently or collaboratively as part of a team

• Technologically adept with Microsoft Office (Excel, PowerPoint, Outlook, Word)

🏝️ Benefits

• An energetic, innovative workplace with a team of intelligent, motivated professionals

• Flexibility for remote work and the opportunity to influence healthcare delivery across the nation

• Growth and mentorship opportunities through our structured coaching initiative

• A collaborative environment where your ideas and perspectives are appreciated

• Genuine opportunities for career advancement—your trajectory here is determined by your efforts!