Outpatient Auditor III

EXL Talent Acquisition Team; Jacksonville (FL); Remote; USD 70,000 - 90,000; Full time

Benefits offered by this job

Pay for Performance Bonus

Job summary

EXL Health is seeking an experienced Outpatient Facility Auditor with APC reimbursement expertise to audit hospital outpatient facility claims (UB-04), focusing on CPT/HCPCS coding, APC payment methodologies, and CMS OPPS guidelines. This remote role is US-based and allows you to work from home while applying in-depth regulatory knowledge.

You will join a remote auditing team dedicated to facility-based outpatient services, ensuring accurate APC assignments, proper packaging, and compliant

Qualifications

• Experience auditing APC and facility claims.
• Strong CPT/HCPCS coding knowledge.
• Knowledge of CMS OPPS guidelines.
• Remote auditing experience preferred.

Responsibilities

• Audit UB-04 facility claims to ensure correct APC assignment.
• Review APC groupings and status indicators for accuracy.
• Ensure compliant facility billing and proper packaging.
• Prepare audit findings and recommendations for improvement.

Skills

CPT/HCPCS coding

APC reimbursement

CMS OPPS guidelines

UB-04 auditing

Outpatient facility coding

Job description

Are you an experienced Outpatient Facility Auditor with strong APC reimbursement expertise in hospital-based outpatient services? Do you enjoy analyzing APC groupings, status indicators, payment logic, and CMS OPPS compliance across infusion services, outpatient surgeries, and interventional radiology?

EXL Health is seeking a highly skilled auditor to join our growing remote outpatient auditing team, where your work will focus exclusively on facility‑based outpatient claims and APC reimbursement. This role is ideal for auditors who specialize in hospital outpatient facility coding and reimbursement.

As a Remote Certified Outpatient Facility Auditor, you will apply your in‑depth knowledge of CPT/HCPCS coding, APC payment methodologies, and outpatient regulatory guidelines to audit UB‑04 facility claims only, ensuring accurate APC assignment, proper packaging, and compliant facility billing.

Salary Range: $70,000 – $90,000 (based on experience, skills, and qualifications)
Location: 100% Remote (U.S.-based)

This position is eligible for a Pay for Performance Bonus!

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