Remote Quality Analyst - Clinical DRG Validation & Auditing

Ali Aydi; United States; Remoto; USD 60.000 - 99.000; Tempo pieno

Descrizione del lavoro

EXL is seeking a remote Quality Analyst to supervise the Clinical CVA auditing process, ensuring accuracy and consistency across audits. The role includes mentoring auditors, applying clinical judgment to DRG reviews, and driving quality improvements.

The position requires RN licensure and 5+ years of clinical validation audit experience, with strong communication and problem-solving skills to operate under deadlines and regulatory guidelines.

Competenze

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

Mansioni

• Apply clinical judgment for DRG audits to ensure accuracy of inpatient DRG coding.
• Review the accuracy and consistency of clinical DRG auditing auditors 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.
• Ensure compliance with company policies and regulatory requirements.

Conoscenze

Auditing & monitoring

Mentoring

Clinical validation audits

Decision making

Communication

Medical terminology

Self-motivation

Teamwork

Formazione

Registered Nurse license

Strumenti

DRG coding systems

Descrizione del lavoro

EXL is seeking a remote Quality Analyst to supervise the Clinical CVA auditing process, ensuring accuracy and consistency across audits. The role includes mentoring auditors, applying clinical judgment to DRG reviews, and driving quality improvements.

The position requires RN licensure and 5+ years of clinical validation audit experience, with strong communication and problem-solving skills to operate under deadlines and regulatory guidelines.