Outpatient Quality Analyst IV – QC Coder, Healthcare

Join EXL Health as an Outpatient Quality Analyst IV – QC Coder (Remote Opportunity!)

Are you passionate about accuracy in medical coding and ready to make a real impact in healthcare quality? EXL Health is looking for an experienced Outpatient Quality Analyst IV – QC Coder to join our remote team! If you’re a detail-oriented coding professional who thrives on mentoring others and making process improvements, this is the role for you.

Why This Role Rocks:
As a Quality Analyst IV, you’ll be the quality gatekeeper of our outpatient coding audits—ensuring every audit meets EXL’s gold standard for accuracy. You’ll validate coded data against medical documentation, lead quality reviews, and provide expert feedback to elevate performance across the team. Your expertise will help shape training and drive continuous improvement in how we work.

What You’ll Be Doing:

• Review coding audits to ensure findings are accurate, consistent, and compliant.
• Provide coaching and support to coders to enhance accuracy and confidence.
• Deliver feedback from audit reviews and identify training needs or process gaps.
• Contribute to improving audit methods, processes, and documentation.
• Collaborate closely with peers and leadership to drive quality improvements.
• Provide insightful root cause analyses for coding discrepancies.
• Support compliance with company and regulatory standards.
• Take on additional tasks and challenges as needed in a dynamic environment.

What You’ll Bring:

• High School Diploma (required); CCS or CPC certification (required)
• At least 5 years of coding experience across both professional and hospital settings
• Deep knowledge of ICD-10, HCPCS/CPT, Medicare OPPS, and APCs
• Skilled in using encoder tools (Optum, TrueCode, 3M, Webstrat)
• Familiar with Medicare LCD and NCD guidelines
• Ability to code complex outpatient services (e.g., interventional radiology, ambulatory surgery, ER, observation)
• Expertise in applying modifiers and following Medicare/NCCI rules
• Strong documentation skills with the ability to reference official coding guidelines
• Excellent communication, organization, and problem-solving abilities
• Comfortable working independently or as part of a team
• Tech-savvy with Microsoft Office (Excel, PowerPoint, Outlook, Word)

What We Offer You:

• A fast-paced, innovative environment with a team of sharp, driven professionals
• Remote work flexibility and a chance to impact healthcare delivery nationwide
• Opportunities for growth and mentorship through our structured coaching program
• A collaborative culture where your ideas and insights are valued
• Real opportunities for advancement—your future here is what you make it!

At EXL Health, you’ll not only do meaningful work—you’ll grow your career, expand your skills, and be part of a team that values your contribution.

Ready to take your coding career to the next level? Apply today and help us deliver excellence in every audit!