Quality Analyst - Outpatient, Healthcare
EXL•United States,
•$85,000 - $92,000•Remote
About The Position
EXL Health is seeking an experienced Outpatient Quality Analyst – QC Coder to join their remote team. This role focuses on ensuring accuracy in medical coding and healthcare quality. The Quality Analyst will be responsible for the quality of outpatient coding audits, validating coded data against medical documentation, leading quality reviews, and providing feedback to improve team performance. The role also involves shaping training and driving continuous improvement in work processes. A coding/auditing assessment may be part of the interview process.
Requirements
- 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)
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.
Benefits
- Remote work flexibility
- Opportunities for growth and mentorship through our structured coaching program
- A collaborative culture where your ideas and insights are valued
- Real opportunities for advancement
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
