Quality Reviewer - Outpatient

The Outpatient Quality Reviewer is responsible for ensuring the accuracy and compliance of outpatient coding across various areas such as Ancillary, Emergency Department, and Interventional Radiology. They analyze audit results, identify coding trends, and provide expert guidance to coding staff and quality reviewers to promote coding excellence. Partnering with cross-functional teams, they resolve coding issues, support revenue integrity, and stay updated on industry regulations and guidelines to maintain compliance. Key duties include conducting quality reviews of outpatient records, validating CPT®, HCPCS, ICD-10-CM, and APC codes, and facilitating process improvements through training and collaboration. Required qualifications include a high school diploma or GED, active certifications such as RHIT, RHIA, COC, CCS-P, or CCS, and at least seven years of hospital outpatient coding experience. Preferred skills involve a college degree. The role emphasizes continuous learning, teamwork, and maintaining high accuracy and productivity in a remote setting. It offers a competitive hourly pay rate and opportunities for career growth while contributing to improved patient care and community impact.