Quality Analyst – Outpatient, Healthcare

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🕒 Julho 9

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $85.000 - $92.000 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

🧐 Analista

👻 Score fantasma 10%

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🗣️🇺🇸🇬🇧 Inglês obrigatório

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EXL

10.000+ funcionários

🏥 Saúde

🛡️ Seguros

📦 Logística

💰 $2.000.000 Venture Round em 2015-01

Healthcare • Insurance • Logistics

Escolher um parceiro digital vai além das capacidades — trata-se de colaboração e caráter.

Descrição

• 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.

🎯 Requisitos

• 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)

🏖️ Benefícios

• A fast-paced, innovative environment with a team of sharp, driven professionals • 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!

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