Remote Outpatient Coding Quality Reviewer

R1 RCM, Inc.; United States; On-site; USD 81,002,000 - 115,218,000; Full time

Benefits offered by this job

Competitive benefits package

Job summary

R1 RCM, Inc. is seeking an Outpatient Coding Quality Reviewer to review outpatient coded cases across Ancillary, ED, Same Day Surgery, Observation, Wound Care, Professional Services, Interventional Cardiology and Interventional Radiology for accuracy and completeness.

You will provide expert coding guidance to staff and contribute to quality initiatives. This remote role requires strong CPT/HCPCS/ICD-10-CM knowledge, seven years of hospital outpatient coding experience, and relevant

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 (including Ancillary, Emergency Department, Same Day Surgery, Observation, Wound Care, E/M Professional service, Interventional Cardiology, and Interventional Radiology) is required.

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

High School diploma, GED or equivalent

Education

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

Bachelor's or Associate Degree

Job description

R1 RCM, Inc. is seeking an Outpatient Coding Quality Reviewer to review outpatient coded cases across Ancillary, ED, Same Day Surgery, Observation, Wound Care, Professional Services, Interventional Cardiology and Interventional Radiology for accuracy and completeness.

You will provide expert coding guidance to staff and contribute to quality initiatives. This remote role requires strong CPT/HCPCS/ICD-10-CM knowledge, seven years of hospital outpatient coding experience, and relevant