Senior Healthcare Auditor

2 weeks ago


Nashville, Tennessee, United States ExlService Holdings , Inc. Full time

Position Overview:
We are seeking a skilled DRG Auditor III to contribute to our healthcare auditing efforts at EXL Health. This role combines the flexibility of remote work with the opportunity for travel, allowing you to engage with diverse healthcare environments across the country.

Travel Opportunities:
This position involves approximately six weeks of travel each quarter, with visits to various cities, enhancing your professional experience while exploring new locations.

Key Responsibilities:

  1. Thorough Review: Execute comprehensive evaluations of medical documentation and coding to ensure the precision of DRG or APR DRG code assignments.
  2. Onsite Assessments: Conduct facility audits on a quarterly basis, both locally and in other states, with all travel expenses reimbursed.
  3. Documentation: Prepare detailed findings in accordance with EXL policies and established coding standards.
  4. Data Management: Input all necessary DRG review data into our encoder system to achieve validated DRGs.
  5. Issue Identification: Recognize and discuss any ambiguous encoder outcomes with the program manager, escalating facility concerns as necessary.
  6. Audit Tracking: Manage the progress of audits within the audit workflow system.
  7. Compliance Adherence: Follow EXL policies and HIPAA regulations while meeting productivity and quality benchmarks.

Qualifications:
Education: A minimum of a High School Diploma; certifications such as CCS, CIC, or CPC with inpatient experience are preferred.
Experience: At least one year of experience in inpatient hospital coding or auditing is required.
Skills: Excellent verbal and written communication abilities, willingness to travel quarterly, and capacity to work remotely.

Working Environment:
This role involves extended periods of sitting, occasional walking, and light lifting (up to 5 pounds). Regular use of hands for typing and note-taking is essential, along with the ability to read printed materials and engage in verbal and written communication.

Why Choose EXL Health?
Become part of a team that values your expertise and fosters both professional and personal growth. Experience the ideal combination of remote work flexibility and exciting travel opportunities while playing a crucial role in ensuring accurate healthcare payments.


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