Remote Outpatient Quality Reviewer – Coding & Audit Expert

R1-Rc; United States; Remote; USD 39,000 - 55,000; Full time

Benefits offered by this job

Remote work

Competitive benefits package

Job summary

R1 RCM Inc. seeks an Outpatient Quality Reviewer to audit outpatient records for CPT/HCPCS/ICD-10-CM and APC accuracy, provide expert coding guidance across various departments, and drive education and process improvements in a remote team.

The role requires RHIT/RHIA/COC/CCS-P/CCSA certifications and at least seven years of hospital outpatient coding experience. You will partner with Quality, Education, Denials, and Coding Operations to resolve issues, stay updated on CMS/AHA/AMA guidelines,

Qualifications

• Active professional certifications (RHIT/RHIA/COC/CCS-P/CCSA) are required.
• High school diploma or equivalent required; bachelor/associate degree preferred.
• Experience in hospital outpatient coding and CMS/AHA/AMA guidelines is expected.

Responsibilities

• Review outpatient coded cases for accuracy across CPT/HCPCS/ICD-10-CM and APC assignments.
• Identify coding opportunities and research guidelines to support changes.
• Provide expert coding advice and coaching to staff and quality reviewers.
• Analyze audit results to identify education and process-improvement opportunities.
• Collaborate with Quality, Education, Denials, and Coding Operations to resolve issues.
• Stay current on regulatory guidelines and ensure CMS/AHA/AMA compliance.
• Support remote work environment with high accuracy and productivity.

Skills

RHIT

RHIA

COC

CCS-P

CCSA

Quality auditing

Remote work

Education

High School diploma or GED

Bachelor's degree

Associate degree

Job description

R1 RCM Inc. seeks an Outpatient Quality Reviewer to audit outpatient records for CPT/HCPCS/ICD-10-CM and APC accuracy, provide expert coding guidance across various departments, and drive education and process improvements in a remote team.

The role requires RHIT/RHIA/COC/CCS-P/CCSA certifications and at least seven years of hospital outpatient coding experience. You will partner with Quality, Education, Denials, and Coding Operations to resolve issues, stay updated on CMS/AHA/AMA guidelines,