Quality Analyst – Outpatient, Healthcare

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $60.1k - $98.7k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

👻 Ghost score 3%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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 • Validate coded data against medical documentation • 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 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) • Familiarity 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 • Ability to work independently or as part of a team • Proficiency with Microsoft Office, including Excel, PowerPoint, Outlook, and Word • Must be U.S.-based

🏖️ 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 work environment • Chance to impact healthcare delivery nationwide