[Remote] Quality Analyst - Outpatient
Note: The job is a remote job and is open to candidates in USA. EXL Health is seeking an experienced Outpatient Quality Analyst to join their remote team, focusing on ensuring accuracy in medical coding audits. The role involves validating coded data, leading quality reviews, and providing feedback to enhance team performance and drive continuous improvement.
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
Skills
- 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!
Company Overview