High Cost Drug Auditor III

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EXL

WebsiteLinkedInAll Job Openings

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

• Apply expert knowledge of billing HCD claims to perform extensive audit reviews. • Utilize HCPCS codes, medical record review, industry, and EXL proprietary tools in the audit process. • Write professional communications documenting audit findings and supporting rationales. • Identify audit trends and opportunities.

🎯 Requirements

• Three or more years' experience in claims processing or HCD medical billing experience with expert knowledge HCPCS codes. • Experience reading and interpreting contract language and fee schedules and medical record review. • Intermediate skills in Word and basic computer literacy. • Intermediate skills in Excel including comfort working with charts, graphs, and percentages. • Basic math skills with ability to do conversion calculations. • High school diploma obtained • Certified Pharmacy Technician or one or more of the following credentials: RHIA or CPC; preference given to those with multiple credentials. • Expert in HCPCS codes with advanced knowledge of medical terminology. • Experience with encoder tools and industry systems (FACETS, NASCO, Encoder Pro, TrueCode, 3M, Webstrat, Pricers). • Works independently in a remote environment and delivers exceptional results during EXL core business hours. • Possesses excellent time management and work prioritization skills. • Takes ownership of problem solving. • Demonstrates excellent written and verbal communication skills, strong analytical skills, and attention to detail. • Enthusiastic about Auditing with a desire to work in an environment thriving on teamwork, excellence, collaboration, inclusiveness, and support.

🏖️ Benefits

• For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits