Senior Executive - Auditor/QA

EXL Talent Acquisition Team; Chennai; On-site; INR 900,000 - 1,300,000; Full time

Job summary

EXL Talent Acquisition Team in Chennai is seeking a Quality Analyst with 3+ years post-certification experience to perform detailed audits of coded medical records and ensure accuracy and compliance with CPT, ICD-10-CM, and HCPCS guidelines.

You will review clinical documentation, identify coding errors, provide actionable feedback, and collaborate with managers to drive process improvements while staying current with payer regulations and HIPAA/OIG compliance.

Qualifications

• Must have 3+ years of experience after certification.
• Expert in quality audits of coded medical records.
• Experience with CPT, ICD-10-CM and HCPCS coding.
• Able to identify coding errors and provide actionable feedback to the team.
• Stay current with updates to coding standards, payer regulations and HIPAA/OIG requirements.

Responsibilities

• Perform detailed quality audits of coded medical records to ensure accuracy, compliance, and adherence to official coding guidelines and payer-specific requirements.
• Review and analyze clinical documentation for completeness and accuracy in assigning CPT, ICD-10-CM, and HCPCS codes.
• Identify coding errors, trends, and areas for improvement; provide actionable feedback and recommendations to the coding team.
• Collaborate with coding managers and training teams to support process improvement and coding education initiatives.
• Stay current with updates to coding standards, payer regulations, and compliance requirements.

Skills

Quality mindset

Problem solving

Team guidance

Client email handling

Analytical thinking

Process improvement

Education

Bachelor's Degree in Science or Nursing

CCS – Certified Coding Specialist

CPC – Certified Professional Coder

CPMA certification (added advantage)

4-6 years coding with quality experience

1-2 years in Quality Analyst or Quality Auditing

Tools

Microsoft Excel

Job description

• 3+years of experience after certification is must
• Perform detailedquality auditsof coded medical records to ensure accuracy, compliance, and adherence to official coding guidelines and payer-specific requirements.
• Review and analyze clinical documentation for completeness and accuracy in assigning CPT, ICD-10-CM, and HCPCS codes.
• Identify coding errors, trends, and areas for improvement; provide actionable feedback and recommendations to the coding team.
• Collaborate with coding managers and training teams to support process improvement and coding education initiatives.
• Stay current with updates to coding standards, payer regulations, and compliance requirements.

Responsibilities

• Must be an expert
• Working in Quality team is an added advantage.
• Inventory management and planning
• Motivate and guide team to achieve production and quality goal set
• Follow project related protocols and instructions
• Handling team clarification
• To be proactive in handling team issues
• Problem solving skill sets
• Research on grey areas with solution
• Capable of conducting team education and training
• Skill sets to address client email and queries
• Should have more analytical skill sets
• Should be more innovative, energetic and positive thoughts
• Having skill sets to motivate teams
• Escalate issues, identify trends
• All emails from Manager should be answered promptly without fail
• Ensure compliance of entire team for HIPAA,OIG

Qualifications

Education - Bachelor’s Degree in Science or Nursing.

Certifications

One or more of the following mandatory certifications:

3+years of experience after certification is must

CCS – Certified Coding Specialist

CPC – Certified Professional Coder

Experience -

• 4 - 6 year of Coding with quality experience
• Specialty worked: IVR – Mandatory (Must be dealt with complex level IVR coding, cardiovascular surgery and General surgery
• 3+years of experience after certification is must
• CPMA certification is added advantage.
• QC experience

Minimum 1–2 years of experience in a Quality Analyst or Quality Auditing role.

Preferred Qualifications (Desirable Criteria)

Strong proficiency in Microsoft Excel, including trackers, analysis, and reporting.

Experience working in SLA-driven, high-compliance healthcare environments.