Remote Outpatient Facility Auditor - APC Reimbursement

ExlService Holdings, Inc.; 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

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