Clinical Readmission Review Quality Analyst

ExlService Holdings, Inc.; Northern (KY); Hybrid; USD 60,000 - 99,000; Full time

Job summary

ExlService Holdings, Inc. seeks a Clinical Readmission Review Quality Analyst to oversee auditors, perform quality reviews of inpatient records, and ensure audit determinations are clinically supported and well-documented.

The role drives quality improvements and coaching to auditors across the program. The position reports on quality trends, provides feedback, and supports calibration to strengthen audit performance.

Qualifications

• Clinical knowledge applied to reviews of inpatient medical records.
• Experience performing quality reviews or audits preferred.
• Ability to provide actionable feedback and coaching to auditors.

Responsibilities

• Oversee quality reviews of readmission audits performed by Clinical Readmission Review Auditors.
• Apply expert clinical knowledge to verify audit determinations are documented and supported.
• Identify quality trends and provide feedback and coaching to improve performance.
• Recommend process improvements to strengthen overall audit quality and efficiency.

Skills

Clinical knowledge

Quality auditing

Feedback & coaching

Data-driven reviews

Job description

The Clinical Readmission Review Quality Analyst oversees work performed by Clinical Readmission Review Auditors to ensure EXL’s standard of accuracy, consistency, and documentation quality is met. The analyst performs quality reviews of random and targeted samples of completed readmission audits and applies expert clinical knowledge when reviewing inpatient medical records to confirm that audit determinations are clinically supported, appropriately documented, aligned with program requirements, and supported by clear rationale. This role identifies quality trends, provides feedback and coaching support to auditors, supports calibration, and recommends process improvements to strengthen overall audit quality and performance.

Salary Range: $60,100 - $98,700 | Location: 100% Remote, U.S.-based | Travel: Up to 10% annually

A quality review,clinical audit, or written documentation assessment may be included as part of the interview process.

For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits