Certified Quality Analyst

Job Summary

To ensure high standards of accuracy in outpatient coding, the remote Certified Quality Analyst will oversee audit programs, validate coding accuracy against medical documentation, and mentor coding auditors while managing quality reviews and compliance with established guidelines.

Key responsibilities

• Review the accuracy and consistency of coding audits to ensure proper documentation of findings
• Perform quality reviews of medical records and coding audits, identifying errors and trends for improvement
• Mentor coding auditors, providing feedback and recommendations for process enhancements

Required qualifications

• CCS, CPC, or COC certification is required; CPMA, COSC, CCC, or CASCC certification preferred
• Minimum of 5 years of coding experience with a strong understanding of ICD-10-CM and HCPCS/CPT coding systems
• Expertise in Medicare Local Coverage Determinations (LCD) and National Coverage Determinations (NCD)
• Prior experience in coding audits, compliance reviews, or payer-side Payment Integrity audits preferred
• Proficiency in Microsoft Excel, PowerPoint, Outlook, and Word