Healthcare Audit Specialist III
2 weeks ago
Position Overview:
Join EXL Health as a Senior DRG Auditor, where you will play a pivotal role in ensuring the accuracy of healthcare coding and compliance.
Role Highlights:
This position offers a hybrid work environment, combining remote auditing with travel opportunities to various locations across the United States.
Travel Opportunities:
Expect approximately six weeks of travel each quarter, with all travel expenses covered.
Key Responsibilities:
- Thorough Record Review: Conduct comprehensive evaluations of medical records and coding to confirm the correctness of DRG or APR DRG code assignments.
- Onsite Evaluations: Perform onsite audits at healthcare facilities quarterly, with all related expenses reimbursed.
- Documentation: Prepare detailed findings in accordance with EXL policies and official coding standards.
- Data Management: Input necessary DRG review data into our encoder system to secure validated DRGs.
- Issue Identification: Recognize and discuss any questionable encoder outcomes with the program manager, escalating facility concerns as necessary.
- Audit Workflow: Maintain and update the status of audits within the audit workflow system.
- 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 may involve extended periods of sitting, occasional walking, and light lifting. Regular use of hands for typing and note-taking is expected, 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 supports your professional growth. Enjoy a balance of remote work flexibility and exciting travel, all while contributing to the essential task of ensuring accurate healthcare payments.
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