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Clinical Validation Audit Trainer

🕒 August 31

🇺🇸 United States – Remote

💵 $85k - $110k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 12%

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Logo of EXL

EXL

10,000+ employees

🏥 Healthcare

🛡️ Insurance

📦 Logistics

💰 $2M Venture Round on 2015-01

Healthcare • Insurance • Logistics

EXL is a business consulting and services firm that focuses on leveraging data to enhance business operations and decision-making. With a strong emphasis on collaboration and adaptability, EXL partners with organizations to address their unique needs and culture while integrating data science and technology solutions. The company's areas of expertise include operations management, decision analytics, digital transformation, and various industries such as healthcare, finance, and insurance. EXL's mission is to help clients drive business evolution and maintain competitive advantage through tailored solutions and effective use of data.

📋 Description

• Deliver learning experiences to new-hire and tenured CVA coders • Apply clinical and DRG expertise to inpatient DRG validation and coding-accuracy training • Review clinical DRG audit outcomes for consistency and accuracy • Use audit findings to inform training, coaching, and remediation • Mentor and coach Clinical DRG Auditors • Analyze audit trends and identify learning gaps or referral needs • Perform root-cause analysis on audit errors • Translate audit findings into actionable training and performance support • Use industry standards and EXL proprietary tools for DRG validation training • Develop training communications and materials documenting audit scenarios, findings, and clinical rationale • Recommend training and process improvements • Communicate training needs, trends, and progress to peers, auditors, and management • Follow company compliance, information-security, and regulatory requirements • Perform other duties as assigned

🎯 Requirements

• Registered Nurse, associate or bachelor's degree • 5+ years of acute care nursing experience • 2+ years of experience facilitating training delivery • Prior clinical or coding validation audit experience preferred • Prior DRG retrospective overpayment identification auditing experience preferred • Prior readmission (PPR) auditing experience preferred • CCS, RHIA, or RHIT coding credentials preferred • Skill in instructor-led, virtual, and blended training for adult learners • Ability to explain complex coding guidelines and audit concepts • Knowledge of clinical criteria documentation requirements for substantiating code assignments • Experience with DRG encoder tools such as Solventum/3M, TruBridge, and Webstrat • Proficiency in Excel, Word, and OneNote • Comfort with virtual meeting platforms, LMS, and MS Teams • Ability to work remotely during EXL core business hours • Strong analytical, organizational, time-management, written, verbal communication, and attention-to-detail skills

🏖️ Benefits

• 100% remote work from home • Up to 10% annual travel for team meetings and limited client onsite engagements • Mentoring program with guidance/coaching from senior-level professionals • Opportunities to learn from experienced healthcare consultants • Professional and personal growth and development opportunities • Innovative, fast-paced work environment

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