Quality Analyst – Outpatient, Healthcare

🕒 September 21

🇺🇸 United States – Remote

💵 $85k - $92k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

👻 Ghost score 5%

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EXL

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛡️ Insurance

📦 Logistics

💰 $2M Venture Round on 2015-01

Healthcare • Insurance • Logistics

EXL is a business consulting and services firm that focuses on leveraging data to enhance business operations and decision-making. With a strong emphasis on collaboration and adaptability, EXL partners with organizations to address their unique needs and culture while integrating data science and technology solutions. The company's areas of expertise include operations management, decision analytics, digital transformation, and various industries such as healthcare, finance, and insurance. EXL's mission is to help clients drive business evolution and maintain competitive advantage through tailored solutions and effective use of data.

📋 Description

• 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 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

🎯 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, including interventional radiology, ambulatory surgery, ER, and 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) • A brief coding/auditing assessment may be included as part of the interview process

🏖️ Benefits

• Remote work flexibility • Opportunities for growth and mentorship through a structured coaching program • Collaborative culture where ideas and insights are valued • Opportunities for advancement • Fast-paced, innovative environment • Meaningful work impacting healthcare delivery nationwide

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