Remote Outpatient Coding Quality Expert

R1 RCM, Inc.; Boise (ID); Remote; USD 39,000 - 55,000; Full time

Job summary

R1 RCM Inc. seeks an Outpatient Coding Quality Reviewer to ensure accuracy and compliance across outpatient records, including Ancillary, ED, Same Day Surgery, Observation, and Interventional services.

You will share expert coding guidance with staff, analyze audit results, and collaborate with Quality, Education, Denials, and Coding Operations to drive continuous quality improvements in a remote setting. This role requires active certifications and at least seven years of hospital outpatient

Qualifications

• 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.

Responsibilities

• 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.

Skills

CPT/HCPCS/ICD-10-CM coding

Education

RHIT, RHIA, COC, CCS-P or CCS certification

Job description

R1 RCM Inc. seeks an Outpatient Coding Quality Reviewer to ensure accuracy and compliance across outpatient records, including Ancillary, ED, Same Day Surgery, Observation, and Interventional services.

You will share expert coding guidance with staff, analyze audit results, and collaborate with Quality, Education, Denials, and Coding Operations to drive continuous quality improvements in a remote setting. This role requires active certifications and at least seven years of hospital outpatient