Outpatient Auditor II

EXL Talent Acquisition Team; United States; Remote; USD 70,000 - 100,000; Full time

Benefits offered by this job

Fully remote

Up to 10% travel annually

Job summary

EXL Health is seeking a Remote Certified Outpatient Auditor to review outpatient claims, validate CPT codes, and ensure alignment with regulatory guidelines. This role supports providers, payers, and patients by upholding accurate reimbursements.

The position is fully remote with up to 10% annual travel for team meetings and occasional client onsite engagements, offering flexibility and opportunity across diverse clinical specialties.

Qualifications

• Deep expertise in CPT coding for outpatient services.
• Knowledge of APC reimbursement and outpatient regulatory guidelines.
• Experience auditing outpatient claims and identifying discrepancies.

Responsibilities

• Review outpatient claims for accuracy and compliance.
• Identify discrepancies and ensure adherence to CPT and APC guidelines.
• Collaborate with providers, payers, and clients to resolve issues.

Skills

CPT coding knowledge

Regulatory compliance

Auditing experience

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.