Outpatient Auditor II

ExlService Holdings, Inc.; United States; Remote; USD 70,000 - 100,000; Full time

Job summary

ExlService Holdings, Inc. is seeking a Remote Certified Outpatient Auditor to apply expertise in CPT coding, outpatient regulatory guidelines, and APC reimbursement to review claims across clinical specialties.

This fully remote role includes occasional client onsite engagements and travel up to 10% for team meetings, with a focus on accuracy, compliance, and supporting providers, payers, and patients.

Qualifications

• Deep knowledge of CPT coding and outpatient regulatory guidelines.
• Experience validating billed CPT codes and reimbursement.
• Ability to review claims across clinical specialties.

Responsibilities

• Review outpatient claims for accuracy.
• Validate billed CPT codes and APC reimbursement.
• Identify discrepancies and ensure regulatory compliance.
• Support providers, payers, and patients.

Skills

CPT coding

Outpatient auditing

Regulatory compliance

APC reimbursement

Job description

Are you a skilled Outpatient Auditor with deep expertise in infusion services, complex surgeries, interventional radiology, and hospital-based outpatient care? Do you bring a strong commitment to coding accuracy, regulatory compliance, and appropriate reimbursement? If so, EXL Health is excited to welcome you to our remote auditing team!

As a Remote Certified Outpatient Auditor, you'll apply your in-depth knowledge of CPT coding, outpatient regulatory guidelines, and APC reimbursement to review outpatient claims across a variety of clinical specialties. Your work will support providers, payers, and patients by validating billed CPT codes, identifying discrepancies, and ensuring adherence to industry standards.

This role is fully remote, with up to 10% annual travel for team meetings and occasional client onsite engagements.