Quality Analyst IV - Clinical Validation Auditor (CVA), Healthcare

ExlService Holdings, Inc.; New York (NY); Hybrid; USD 60,000 - 95,000; Full time

Job summary

ExlService Holdings, Inc. is seeking an experienced Clinical Validation Auditor (CVA) Quality Analyst for a remote office opportunity. The Quality Analyst IV oversees CVA auditors to ensure accuracy and adherence to EXL’s standards.

Responsibilities include reviewing audits, mentoring staff, and recommending quality improvements. A brief interview may include a coding/auditing assessment. Salary range is $60,000 to $95,000 plus bonus, with the posted range reflecting national hiring scales.

Qualifications

• Current Registered Nurse license.
• 5+ years of experience working with clinical validation audits.

Responsibilities

• Apply clinical judgment for CVA audits to ensure inpatient DRG coding accuracy.
• Review accuracy and consistency of CVA auditing to ensure audits are appropriately marked for findings or no findings.
• Mentor Clinical CVA auditors and provide coaching.
• Recommend processes to improve quality and performance.
• Communicate with peers and management.
• Conduct root cause analyses on errors.

Skills

Auditing and monitoring

Mentoring

Clinical terminology

Decision making

Communication

Analytical thinking

Education

Registered Nurse license

Job description

EXLHealth,isseekinganexperiencedClinicalValidationAuditor(CVA)QualityAnalyst.

Thisisaremoteofficeopportunity.TheQualityAnalystIVoverseesworkperformedbytheClinicalCVAauditorstoensurethatEXL’sstandardofaccuracyismet.TheanalystundertakesaqualityreviewofrandomandtargetedclinicalCVAaudits.

Abriefcoding/auditingassessmentmaybeincludedaspartoftheinterviewprocess

Estimatedsalaryrangeis$60,000to$95,000plusbonus

Formoreinformationonbenefitsandwhatweofferpleasevisitusat https://www.exlservice.com/us-careers-and-benefits

Thepostedrangeisthehiringrangeforthisrole—a subsetofthebroaderrangeavailabletoemployeesovertime—andreflectsbasesalaryacrossournationalhiringscale.Finaloffersarebasedonseveralfactors,includingthecandidate'sskillsandexperience,internalpayequity,worklocation,marketconditionsfortherole,andthespecificscopeandresponsibilitiesoftheposition.

Thetopoftherangeisreservedforcandidateswhonotablyexceedtherequirements;thelowerendappliestothosewithlessexperienceorfewerpreferredqualifications.Forpositionsbasedinhigher-costzones(e.g.,California,NewYork,NewJersey),actualcompensationmayexceedthepostedrange;yourrecruiterwillsharespecificsduringtheprocess.

Responsibilities

• ApplyclinicaljudgmentforCVAauditstoensureaccuracyofinpatientDRGcoding
• ResponsibleforreviewingtheaccuracyandconsistencyofclinicalCVAauditingauditorstoensureauditsareappropriatelymarkedforfindingsandnofindings
• MentorClinicalCVAauditors
• Recommendprocesschangestoimprovequalityandperformance
• Communicatewithpeersandmanagement
• Providerootcauseanalysisonerrors
• Performotherdutiesasassigned
• ConductalljobfunctionsandresponsibilitiesinaccordancewithallcompanyCompliance,InformationSecurityandRegulatorypolicies,proceduresandprograms

Qualifications

• CurrentRegisteredNurselicense
• 5plusyearsexperienceworkingwithclinicalvalidationaudits

KnowledgeandSkills:

• Superiorauditingandmonitoringskills
• Abilitytomentorandinstruct
• Excellentdecisionmakingskillsandsoundjudgment
• Thoroughunderstandingofmedicalterminologyandhumanphysiology
• Strongtechnicalknowledgeandabilitytolearnnewsystemsquickly
• Excellentoral/presentationandwrittencommunicationskills
• Abilitytocompletetasksefficientlyandresolveproblemswithinsettimelines
• Strongorganizationalskillsandattentiontodetail
• Abilitytoworkinateamenvironmentandindependentlyasneeded
• Demonstratedflexibilityandadaptability
• Mustbeabletoworkunderdeadlines.Mustbeabletoutilizeindependentdecision-makingskillsinawidevarietyofsituations
• Requiresahighdegreeofaccuracyintheperformanceofvariedresponsibilities.
• Personalcomputerskillsrequired.Mustbeself-motivatedtocompleteworkinatimelymannertomeetdeadlines
• Stronginterpersonalskillsrequired