Clinical Validation Auditor (CVA) Auditor III

ExlService Holdings, Inc.; Northern (KY); Hybrid; USD 70,000 - 85,000; Full time

Benefits offered by this job

Fully remote

Travel up to 10%

Job summary

EXL Service Holdings, Inc. is seeking a Clinical Validation Auditor who uses clinical judgment to review medical records, validate billed DRG codes, and help identify overpayments. This is a fully remote role based in the United States, offering a competitive salary and the chance to impact reimbursement accuracy.

Expect up to 10% annual travel for team meetings and limited client onsite engagements. A brief coding/auditing assessment may be included in the interview process.

Qualifications

• Nurse with inpatient care experience.
• Experience in medical coding/auditing preferred.
• Ability to review medical records and identify discrepancies.

Responsibilities

• Review medical records for accuracy and completeness.
• Validate billed DRG codes and coding accuracy.
• Identify potential overpayments and raise findings for remedy.

Skills

Clinical judgment

Medical records review

DRG coding

Job description

Are you a nurse with a strong understanding of inpatient care and a passion for getting the details right? Join EXL as a Clinical Validation Auditor and help ensure medical claims are coded accurately and fairly. This is a fully remote position where you'll use your clinical judgment to review medical records, validate billed DRG codes, and help identify overpayments.

Salary Range: $70,000 - $85,000 (based on experience, skills, and qualifications)
Location: 100% Remote (U.S.-based)

Up to 10% annual travel (for team meetings and limited client onsite engagements.)

A brief coding/auditing assessment may be included as part of the interview process

The posted range is the hiring range for this role - a subset of the broader range available to employees over time - and reflects base salary across our national hiring scale. Final offers are based on several factors, including the candidate's skills and experience, internal pay equity, work location, market conditions for the role, and the specific scope and responsibilities of the position. The top of the range is reserved for candidates who notably exceed the requirements; the lower end applies to those with less experience or fewer preferred qualifications. For positions based in higher-cost zones (e.g., California, New York, New Jersey), actual compensation may exceed the posted range; your recruiter will share specifics during the process.