Outpatient Auditor III

EXL Talent Acquisition Team; United States; À distance; USD 70 000 - 90 000; Plein temps

Avantages offerts par ce poste

Remote work

Travel up to 10%

Résumé du poste

EXL Health is seeking an experienced Outpatient Facility Auditor to join a remote team focused on facility-based outpatient claims and APC reimbursement. The role emphasizes CPT/HCPCS coding, APC payment methodologies, and CMS OPPS compliance for infusion services, outpatient surgeries, and interventional radiology.

The position offers 100% remote work in the United States with travel up to 10% for team meetings and limited client onsite engagements.

Qualifications

• Experience auditing hospital outpatient facility claims.
• In-depth knowledge of APC payment methods.
• Familiarity with CMS OPPS compliance.

Responsabilités

• Audit facility UB-04 claims for correct APC assignment.
• Validate proper packaging and compliant facility billing.
• Support remote audit team with accurate documentation.

Connaissances

CPT/HCPCS coding

APC reimbursement

OPPS guidelines

UB-04 claims

data analysis

Description du poste

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)

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