Quality Analyst – Outpatient, Healthcare

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

📋 Description

• Evaluate coding audits to confirm that findings are precise, consistent, and in compliance.

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

• Provide insights from audit evaluations and identify areas for training or process improvements.

• Participate in the enhancement of audit techniques, procedures, and documentation.

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

• Conduct root cause analyses for discrepancies in coding.

• Ensure adherence to company policies and regulatory standards.

• Undertake additional responsibilities and challenges as required in a dynamic setting.

⛳️ 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 (Optum, TrueCode, 3M, Webstrat).

• Familiarity with Medicare LCD and NCD guidelines.

• Capability to code 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 capability to reference official coding guidelines.

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

• Comfortable working autonomously or collaboratively within a team.

• Tech-savvy with proficiency in Microsoft Office (Excel, PowerPoint, Outlook, Word).

• A brief coding/auditing assessment may be part of the interview process.

🏝️ Benefits

• Flexibility for remote work.

• Opportunities for development 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 contributions that impact healthcare delivery nationwide.