Quality Analyst - Outpatient

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

• A 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.
• 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).

Pay

Salary Range: $85,000 – $92,000 (based on experience, skills, and qualifications)

Schedule

100% Remote (U.S.-based)

Benefits

For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits