Outpatient Quality Reviewer

R1 RCM

. Review outpatient coded cases for coding completeness and accuracy .

Posted 9/29/2026full-timeRemote • United StatesSeniorLead💰 $28 - $40 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Expertise in outpatient coding, including CPT®, HCPCS, ICD-10-CM, and APC code assignments, with a strong focus on quality assurance, process improvement, and regulatory compliance. Proven ability to provide coding education and collaborate with cross-functional teams to enhance revenue integrity.

Highest-signal resume keywords

Outpatient Coding ExperienceCPT® Code AssignmentICD-10-CM KnowledgeRHIT CertificationQuality Review and Analysis

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

CPT® CodingHCPCS CodingICD-10-CM CodingModifier AssignmentAPC Code AssignmentCoding Completeness ReviewAudit FeedbackProcess ImprovementCoding EducationRegulatory Compliance

Soft Skills

CommunicationCollaborationCoachingAnalytical ThinkingProblem Solving

Certifications & Qualifications

RHITRHIACOCCCS-PCCS

Industry Keywords

CMS RegulationsAHA GuidelinesAMA GuidelinesRevenue IntegrityQuality Enhancement

About the role

Key responsibilities & impact

Review outpatient coded cases for coding completeness and accuracy
Identify potential coding and APC/payment opportunities
Research appropriate guidelines to support recommended changes
Communicate coding changes to coders or quality reviewers in a timely manner
Provide expert coding advice to coding staff and global quality reviewers
Relay needed coding education topics to the Manager of Outpatient Coding Quality
Conduct quality reviews of outpatient records and validate CPT®, HCPCS, ICD-10-CM, modifier, and APC code assignments
Provide audit feedback, coaching, and guidance
Analyze audit results and identify trends for education, process improvement, and quality enhancement
Partner with Quality, Education, Denials, and Coding Operations teams to resolve coding issues and support revenue integrity initiatives
Stay current on industry regulations and coding guidelines
Drive continuous improvement through collaboration, training, and process optimization while maintaining accuracy, productivity, and performance in a remote environment

Requirements

What you’ll need

High School diploma, GED or equivalent
Required one or more active certification(s): RHIT, RHIA, COC, CCS-P or CCS
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
Preferred Bachelor's or Associate Degree
Knowledge of CPT®, HCPCS, ICD-10-CM, modifier, and APC code assignments
Knowledge of CMS, AHA, AMA, and other regulatory requirements

Benefits

Comp & perks

Competitive benefits package
Opportunities to constantly learn, collaborate across groups, and explore new career paths
Opportunity to contribute, think boldly, and create meaningful work
Reasonable accommodation support for applicants with disabilities