EXL
10,000+ employees
💰 $2M Venture Round on 2015-01
Choosing a digital partner is about more than capabilities — it’s about collaboration and character.
Clinical Validation Auditor – Auditor III
🕒 April 3
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EXL
10,000+ employees
💰 $2M Venture Round on 2015-01
Choosing a digital partner is about more than capabilities — it’s about collaboration and character.
📋 Description
• Review inpatient medical records to verify that the DRG (Diagnosis-Related Group) code makes sense based on the documentation. • Apply clinical and coding knowledge to spot inaccuracies and identify potential overpayments. • Document your findings in clear, professional language that explains the rationale behind your review. • Use industry tools like 3M or Webstrat to support your decisions. • Work independently while meeting productivity and quality goals. • Stay up to date with clinical guidelines, DRG rules, and industry trends.
🎯 Requirements
• Registered Nurse (RN) with an active license. • 5+ years of acute care experience (hospital setting preferred) • Experience in DRG audits or coding validation is a big plus! • Bonus points if you have certifications like CCS, RHIA, or RHIT • Knowledge of readmission reviews (PPR) is also a plus • Love digging into the details and solving problems • Know how to explain clinical decisions clearly and professionally • Can manage your time well and stay focused working remotely • Are comfortable using tools like Excel, Word, and OneNote • Enjoy working as part of a supportive, high-performing team
🏖️ Benefits
• Flexible work arrangements • Professional development opportunities
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