Outpatient Coding Quality Reviewer

Responsibilities

• This position identifies potential coding and APC/payment opportunities, research appropriate guidelines to support recommended changes, and communicates the changes to the coder or quality reviewer involved on a timely basis.
• The Outpatient Quality Reviewer provides expert coding advice to coding staff, global quality reviewers and relays needed coding educational topics to the Manager of Outpatient Coding Quality.
• Here is what you will experience working as an Outpatient Coding Quality Reviewer: Ensure coding accuracy and compliance by conducting quality reviews of outpatient records and validating CPT®, HCPCS, ICD-10-CM, modifier, and APC code assignments.
• Serve as a trusted coding subject matter expert , providing audit feedback, coaching, and guidance that promotes coding excellence and consistency across teams.
• Analyze audit results and identify trends to uncover opportunities for education, process improvement, and quality enhancement.
• Partner with cross-functional teams , including Quality, Education, Denials, and Coding Operations, to resolve coding issues and support revenue integrity initiatives.
• Stay current on industry regulations and coding guidelines , ensuring compliance with CMS, AHA, AMA, and other regulatory requirements.
• Drive continuous improvement through collaboration, training, and process optimization while maintaining exceptional accuracy, productivity, and performance in a remote environment.

Requirements

• High School diploma, GED or equivalent Required one or more active certification(s): RHIT, RHIA, COC, CCS-P or CCS A minimum of seven (7) years of hospital outpatient coding experience (including Ancillary, Emergency Department, Same Day Surgery, Observation, Wound Care, E/M Professional service, Interventional Cardiology, and Interventional Radiology) is required.

Preferred Skills

Bachelor's or Associate Degree For this US-based position, the base pay range is $28.24 - $40.21 per hour . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training. The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career. Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a competitive benefits package. R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories. If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.

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