Outpatient Coding Quality Associate

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. 

Our Outpatient Coding Quality Associate will be responsible for reviewing clinical documentation and diagnostic results as appropriate (i.e., to extract data and apply appropriate ICD-10-CM, HCPCS and CPT-4 codes for billing, review and correct billing edits, internal and external reporting, research, and regulatory compliance). Under the direction of the Coding Leadership Team, the successful candidate must be able to accurately code conditions and procedures as documented in the ICD-10-CM Official Guidelines for Coding and Reporting. 

Here is what you can expect as our Outpatient Coding Quality Associate: 

• Review outpatient coded records for completeness and accuracy, meeting department standards for high productivity and at least 95% accuracy in professional services coding.

• Identify coding errors, research applicable AMA, payer, and regulatory guidelines, and communicate timely corrections and audit findings to coders.

• Perform retrospective coding quality audits and help resolve local coding issues to improve overall coding consistency and compliance.

• Serve as a coding subject matter expert and resource for coding staff and other departments, including support with education based on audit results.

• Maintain current knowledge of official coding conventions, documentation requirements, government regulations, and commercial payer guidelines.

• Support reporting and performance improvement efforts by helping analyze audit data, identify workflow or audit tool improvements, and assist with testing updates as needed.

• Preferred qualifications include experience with edits and denials, strong communication skills, proficiency with standard office systems, and the ability to prioritize shifting workloads to meet department and revenue cycle goals.

Required Qualifications: 

• Three (3) years' experience in Outpatient coding

• Credentials: CCS, COC, CPC, RHIA or RHIT

The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career.

Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a competitive benefits package.

R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.

If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.

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To learn more, visit: R1RCM.com

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