Remote Outpatient Coding Quality Specialist

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

Job summary

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

The role requires seven years of hospital outpatient coding experience and active certifications such as RHIT, RHIA, COC, CCS-P or CCS, with a focus on CMS/AHA/AMA guidelines and remote collaboration.

Qualifications

• A minimum of seven (7) years of hospital outpatient coding experience.
• Active certification(s): RHIT, RHIA, COC, CCS-P or CCS.
• High School diploma, GED or equivalent.

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.

Job description

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

The role requires seven years of hospital outpatient coding experience and active certifications such as RHIT, RHIA, COC, CCS-P or CCS, with a focus on CMS/AHA/AMA guidelines and remote collaboration.