Remote Outpatient Coding Quality Specialist

R1 RCM Holdco Inc.; Illinois; Hybrid; USD 39,000 - 55,000; Full time

Job summary

R1 RCM Inc. is seeking an Outpatient Quality Reviewer to audit outpatient coding for accuracy across CPT®, HCPCS, ICD-10-CM, modifiers and APCs. You will advise coding staff and educate teams while collaborating with Quality, Education, Denials, and Coding Operations.

You will stay current with CMS, AMA, and industry guidelines, supporting continuous improvement, remote work, and performance standards in a healthcare revenue cycle environment.

Qualifications

• Must have High School diploma or GED.
• Minimum seven (7) years of hospital outpatient coding experience including Ancillary, Emergency Department, Same Day Surgery, Observation, Wound Care, E/M Professional services, Interventional Cardiology, and Interventional Radiology.

Responsibilities

• Review outpatient records to ensure CPT, HCPCS, ICD-10-CM, modifier, and APC code assignments are complete and accurate.
• Provide audit feedback and coaching to promote coding excellence and consistency across teams.
• Analyze audit results and identify trends for education, process improvement, and quality enhancement.
• Collaborate with Quality, Education, Denials, and Coding Operations to resolve coding issues and support revenue integrity.
• Stay current on CMS, AHA, AMA guidelines to ensure regulatory compliance.
• Support a remote environment with a focus on accuracy, productivity, and performance.

Education

High School diploma or GED

RHIT

RHIA

COC

CCS-P

CCS

Bachelor's or Associate Degree

Job description

R1 RCM Inc. is seeking an Outpatient Quality Reviewer to audit outpatient coding for accuracy across CPT®, HCPCS, ICD-10-CM, modifiers and APCs. You will advise coding staff and educate teams while collaborating with Quality, Education, Denials, and Coding Operations.

You will stay current with CMS, AMA, and industry guidelines, supporting continuous improvement, remote work, and performance standards in a healthcare revenue cycle environment.