Senior Remote Outpatient Coding Quality Reviewer

R1 RCM, Inc.; United States; Remote; USD 39,000 - 55,000; Full time

Job summary

R1 RCM, Inc. is seeking an Outpatient Quality Reviewer to assess outpatient coding accuracy across CPT®, HCPCS, ICD-10-CM, modifiers, and APCs. You will provide expert guidance to coding staff and quality reviewers and share insights to improve processes.

The role calls for seven years of hospital outpatient coding experience, RHIT/RHIA/COC/CCS-P/CCS credentials, and a remote work setup. A bachelor’s or associate degree is preferred, with competitive compensation based on location and experience.

Qualifications

• High School diploma, GED or equivalent.
• 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

Coding accuracy

Regulatory compliance

Cross-functional collaboration

Education

Bachelor’s or Associate Degree

Job description

R1 RCM, Inc. is seeking an Outpatient Quality Reviewer to assess outpatient coding accuracy across CPT®, HCPCS, ICD-10-CM, modifiers, and APCs. You will provide expert guidance to coding staff and quality reviewers and share insights to improve processes.

The role calls for seven years of hospital outpatient coding experience, RHIT/RHIA/COC/CCS-P/CCS credentials, and a remote work setup. A bachelor’s or associate degree is preferred, with competitive compensation based on location and experience.