Clinical Validation Auditor (CVA) Auditor III

EXL; Pittsburgh (Allegheny County); Remote; USD 60,000 - 99,000; Full time

Job summary

EXL is seeking a Clinical Validation Auditor for a fully remote role based in the United States. You will use clinical judgement to review medical records, validate DRG codes, and help identify overpayments.

The position requires a nursing background with inpatient care knowledge and a meticulous approach. Salary range: $60,100 - $98,700 annually, with up to 10% travel for team meetings and limited client onsite engagements.

Qualifications

• Nurse with inpatient care background and strong attention to detail.
• Experience reviewing medical records for billing accuracy.

Responsibilities

• Review medical records to ensure inpatient care accuracy.
• Validate billed DRG codes for accuracy and fairness.
• Identify potential overpayments and flag discrepancies.

Skills

Clinical validation

Medical records review

DRG coding

Nursing/healthcare experience

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 judgement to review medical records, validate billed DRG codes, and help identify overpayments.

Salary Range: $60,100 - $98,700(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

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