Quality Analyst – Outpatient, Healthcare

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

📋 Description

• Evaluate coding audits to verify that findings are precise, consistent, and compliant.

• Offer coaching and assistance to coders to boost their accuracy and confidence.

• Provide feedback from audit evaluations and pinpoint training needs or process deficiencies.

• Participate in enhancing audit methodologies, processes, and documentation.

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

• Conduct root cause analyses for discrepancies in coding.

• Ensure adherence to company policies and regulatory standards.

• Accept additional responsibilities and challenges as required.

⛳️ 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).

• Familiar with Medicare LCD and NCD guidelines.

• Capability to code complex outpatient services, such as interventional radiology, ambulatory surgery, ER, and observation.

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

• Strong documentation abilities with knowledge of official coding guidelines.

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

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

• Ability to work independently or collaboratively as part of a team.

• Capability to complete a brief coding/auditing assessment during the interview process.

🏝️ Benefits

• Flexibility to work remotely.

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

• A collaborative culture that values ideas and insights.

• Opportunities for career advancement.

• A fast-paced, innovative work environment.

• Meaningful work that has an impact on healthcare delivery nationwide.