Remote Outpatient Quality Lead for Coding & Audits

ExlService Holdings, Inc.; Northern (KY); Hybrid; USD 100,000 - 120,000; Full time

Job summary

ExlService Holdings, Inc. is seeking a leader to manage a team of outpatient quality analysts responsible for auditing auditor-completed outpatient facility coding reviews, validating accuracy, and ensuring compliant coding, billing, and documentation outcomes.

The role requires strong leadership and analytical skills with expertise in ICD-10-CM, CPT, HCPCS, modifiers, OPPS/APC reimbursement, NCCI edits, LCD/NCD requirements, and payer policies. 100% remote, U.S.-based.

Qualifications

• Leadership experience in outpatient quality auditing.
• Expertise in ICD-10-CM, CPT and HCPCS coding rules.
• Familiarity with OPPS/APC reimbursement and NCCI edits.
• Knowledge of LCD/NCD requirements and payer policies.

Responsibilities

• Directly manages a team of outpatient quality analysts.
• Reviews auditor-completed outpatient facility coding audits.
• Validates audit accuracy and ensures correct coding, billing, reimbursement and documentation.
• Leads with strong analytical skills to uphold standards and improve processes.

Skills

Leadership

ICD-10-CM

CPT

HCPCS

OPPS/APC

NCCI edits

LCD/NCD

Payer policies

Audit tools

Quality review standards

Job description

ExlService Holdings, Inc. is seeking a leader to manage a team of outpatient quality analysts responsible for auditing auditor-completed outpatient facility coding reviews, validating accuracy, and ensuring compliant coding, billing, and documentation outcomes.

The role requires strong leadership and analytical skills with expertise in ICD-10-CM, CPT, HCPCS, modifiers, OPPS/APC reimbursement, NCCI edits, LCD/NCD requirements, and payer policies. 100% remote, U.S.-based.