Outpatient Quality Analyst

About the Role

EXL Health is looking for an experienced Outpatient Quality Analyst to join our remote team. As a Quality Analyst, you'll be the quality gatekeeper of our outpatient coding audits—ensuring every audit meets EXL's gold standard for accuracy. You'll validate coded data against medical documentation, lead quality reviews, and provide expert feedback to elevate performance across the team. Your expertise will help shape training and drive continuous improvement in how we work.

Responsibilities

• Review coding audits to ensure findings are accurate, consistent, and compliant
• Provide coaching and support to coders to enhance accuracy and confidence
• Deliver feedback from audit reviews and identify training needs or process gaps
• Contribute to improving audit methods, processes, and documentation
• Collaborate closely with peers and leadership to drive quality improvements
• Provide insightful root cause analyses for coding discrepancies
• Support compliance with company and regulatory standards
• Take on additional tasks and challenges as needed in a dynamic environment

Qualifications

• High School Diploma (required); CCS or CPC certification (required)
• At least 5 years of coding experience across both professional and hospital settings
• Deep knowledge of ICD-10, HCPCS/CPT, Medicare OPPS, and APCs
• Skilled in using encoder tools (Optum, TrueCode, 3M, Webstrat)
• Familiar with Medicare LCD and NCD guidelines
• Ability to code complex outpatient services (e.g., interventional radiology, ambulatory surgery, ER, observation)
• Expertise in applying modifiers and following Medicare/NCCI rules
• Strong documentation skills with the ability to reference official coding guidelines
• Excellent communication, organization, and problem-solving abilities
• Comfortable working independently or as part of a team
• Tech-savvy with Microsoft Office (Excel, PowerPoint, Outlook, Word)

Benefits

• Remote work flexibility and a chance to impact healthcare delivery nationwide
• Opportunities for growth and mentorship through our structured coaching program
• A collaborative culture where your ideas and insights are valued
• Real opportunities for advancement—your future here is what you make it!

Pay

Salary Range: $85,000 – $92,000 (based on experience, skills, and qualifications). The posted range is the hiring range for this role — a subset of the broader range available to employees over time — and reflects base salary across our national hiring scale. Final offers are based on several factors, including the candidate's skills and experience, internal pay equity, work location, market conditions for the role, and the specific scope and responsibilities of the position. The top of the range is reserved for candidates who notably exceed the requirements; the lower end applies to those with less experience or fewer preferred qualifications. For positions based in higher-cost zones (e.g., California, New York, New Jersey), actual compensation may exceed the posted range; your recruiter will share specifics during the process.

Schedule

100% Remote (U.S.-based)