Quality Analyst – Outpatient, Healthcare

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

📋 Description

• Conduct reviews of coding audits to confirm that findings are accurate, consistent, and compliant.

• Verify coded data against medical documentation.

• Offer coaching and support to coders to improve accuracy and build confidence.

• Provide feedback from audit reviews and identify training needs or areas for process improvement.

• Contribute to the enhancement of audit methods, processes, and documentation.

• Work collaboratively with peers and leadership to promote quality improvements.

• Conduct root cause analyses for discrepancies in coding.

• Ensure compliance with company policies and regulatory standards.

• Accept additional tasks and challenges as required in a dynamic work 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 using encoder tools such as Optum, TrueCode, 3M, and Webstrat.

• Familiar with Medicare LCD and NCD guidelines.

• Capable of coding complex outpatient services, including interventional radiology, ambulatory surgery, ER, and observation.

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

• Strong documentation skills with the ability to reference official coding guidelines.

• Excellent communication, organizational, and problem-solving skills.

• Ability to work independently as well as collaboratively within a team.

• Proficient in Microsoft Office applications, including Excel, PowerPoint, Outlook, and Word.

• Must be based in the U.S.

🏝️ Benefits

• Flexibility for remote work.

• Opportunities for professional growth and mentorship through a structured coaching program.

• A collaborative culture where ideas and insights are appreciated.

• Potential for advancement.

• A fast-paced and innovative work environment.

• The opportunity to make a significant impact on healthcare delivery nationwide.