Remote DRG Quality Auditor & Mentor

EXL; United States; Remote; USD 85,000 - 100,000; Full time

Benefits offered by this job

Remote work

Job summary

EXL Health is seeking a remote CVA Quality Analyst in the United States to oversee clinical auditors and ensure accuracy of inpatient DRG coding through quality reviews and expert clinical judgment.

This role also involves mentoring auditors, identifying audit trends, performing root cause analysis, and communicating findings while supporting process improvements. Travel up to 10% and a base salary of $85k-$100k.

Qualifications

• RN with 5+ years of acute care nursing experience; prior clinical or coding validation audit experience preferred.
• DRG retrospective overpayment auditing and readmission auditing experience preferred.
• CCS, RHIA, or RHIT credentials preferred.

Responsibilities

• Apply clinical judgment for DRG audits to ensure inpatient coding accuracy.
• Review accuracy and consistency of DRG auditing audits; ensure appropriate findings./no findings.
• Mentor Clinical DRG auditors.
• Identify audit trends and referrals for DRG coding review.
• Provide root cause analysis on errors.
• Use industry and EXL tools in DRG assignment process.
• Document findings and rationales in professional communications.
• Suggest process changes to improve quality and performance.
• Communicate with peers and management.
• Comply with company policies and regulatory requirements.

Skills

Auditing

Mentoring

Time management

Communication

Analytical skills

Problem solving

Education

RN license or nursing degree

Tools

Solventum/3M

TruBridge

Webstrat

Excel

Word

OneNote

Job description

EXL Health is seeking a remote CVA Quality Analyst in the United States to oversee clinical auditors and ensure accuracy of inpatient DRG coding through quality reviews and expert clinical judgment.

This role also involves mentoring auditors, identifying audit trends, performing root cause analysis, and communicating findings while supporting process improvements. Travel up to 10% and a base salary of $85k-$100k.