Outpatient- Quality Manager

Ex; United States; Remote; USD 100,000 - 120,000; Full time

Job summary

Ex is seeking a senior leader to direct a team of outpatient quality analysts responsible for auditing auditor-completed outpatient facility coding audits and validating audit accuracy. The role focuses on ensuring precise coding, billing, and documentation outcomes while adhering to payer policies and APC reimbursement rules.

The ideal candidate demonstrates strong leadership, analytical skills, and in-depth knowledge of ICD-10-CM, CPT, HCPCS, modifiers, NCCI edits, LCD/NCD requirements, and

Qualifications

• Leadership experience managing a team of auditors.
• Experience reviewing outpatient facility coding audits.
• Strong knowledge of ICD-10-CM, CPT, HCPCS and modifiers.

Responsibilities

• Directly manages a team of outpatient quality analysts.
• Reviews auditor-completed outpatient facility coding audits for accuracy.
• Ensures accurate coding, billing, reimbursement, and documentation outcomes.
• Leads with strong analytical skills and industry standards.

Skills

Leadership

Auditing expertise

ICD-10-CM

CPT/HCPCS

OPPS/APC knowledge

NCCI edits

Payer policies

Data analysis

Audit tools

Outpatient quality review

Job description

The role directly manages a team of outpatient quality analysts responsible for reviewing auditor-completed outpatient facility coding audits, ATA audits, validating audit accuracy, and ensuring accurate coding, billing, reimbursement, and documentation outcomes. The ideal candidate demonstrates strong leadership and analytical skills, along with expertise in ICD-10-CM, CPT, HCPCS, modifiers, OPPS/APC reimbursement, NCCI edits, LCD/NCD requirements, payer policies, audit tools, and outpatient quality review standards.

Salary Range: $100,000 – $120,000, based on experience, skills, and qualifications.

Location: 100% Remote, U.S.-based.

Travel: Limited travel may be required for team meetings.

A brief outpatient coding/auditing assessment may be included as part of the interview process.

For more information on benefits and what we offer, please visit us at https://www.exlservice.com/us-careers-and-benefits.

For more information on benefits and what we offer, please visit us at https://www.exlservice.com/us-careers-and-benefits.