Remote Clinical Validation QA Auditor - DRG Audits

Zim Directory; United States; Remoto; USD 60.000 - 99.000; Tempo pieno

Descrizione del lavoro

EXL (NASDAQ: EXLS) is a leading data analytics and digital operations and solutions company. We partner with clients using a data and AI-led approach to reinvent business models, drive better business outcomes and unlock growth with speed.

This remote office opportunity oversees clinical CVA audits to ensure accuracy and quality. Responsibilities include DRG audit quality checks, mentoring auditors, process improvements, and clear communication with peers and management.

Competenze

• Current RN license is required.
• 5+ years experience working with clinical validation audits.
• Strong auditing and monitoring skills.
• Excellent oral/written communication skills.
• Ability to mentor and instruct others.

Mansioni

• Apply clinical judgment for DRG audits to ensure accuracy of inpatient DRG coding
• Review accuracy and consistency of clinical DRG audits to ensure audits are appropriately marked for findings and no findings
• Mentor Clinical DRG auditors
• Recommend process changes to improve quality and performance
• Communicate with peers and management
• Provide root cause analysis on errors
• Perform other duties as assigned
• Conduct all job functions and responsibilities in accordance with all company Compliance, Information Security and Regulatory policies, procedures and programs

Conoscenze

Auditing expertise

Mentor auditors

Decision making

Medical terminology

Communication skills

Formazione

RN license

Descrizione del lavoro

EXL (NASDAQ: EXLS) is a leading data analytics and digital operations and solutions company. We partner with clients using a data and AI-led approach to reinvent business models, drive better business outcomes and unlock growth with speed.

This remote office opportunity oversees clinical CVA audits to ensure accuracy and quality. Responsibilities include DRG audit quality checks, mentoring auditors, process improvements, and clear communication with peers and management.