Clinical Validation Audit Trainer

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $75.1k - $107.3k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 2%

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EXL

WebsiteLinkedInAll Job Openings

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 engaging 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, informing training, coaching, and remediation • Mentor and coach Clinical DRG Auditors through targeted education, feedback, and knowledge reinforcement • Analyze audit trends and identify learning gaps or referrals for additional DRG coding education or review • Perform root-cause analysis on audit errors and translate findings into actionable training and performance support • Use industry standards and EXL proprietary tools to support DRG validation training and education • Develop training communications and materials documenting audit scenarios, findings, and clinical rationale • Recommend training and process improvements to enhance audit quality and performance outcomes • 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 • Demonstrated training facilitation skills, including instructor-led, virtual, and blended training for adult learners • Ability to explain complex coding guidelines and audit concepts clearly and practically • Strong communication and facilitation skills • Analytical skills to identify knowledge gaps, recurring errors, and training opportunities from audit trends • Extensive knowledge of clinical criteria documentation requirements used to substantiate code assignments • Ability to collaborate with Quality, Audit, and SME partners in a cross-functional remote environment • Strong organizational, time-management, and work-prioritization skills • Experience with DRG encoder tools: Solventum/3M, TruBridge, and Webstrat • Ability to work independently in a remote environment during EXL core business hours • Excellent written and verbal communication, analytical skills, and attention to detail • Proficiency in Excel, Word, and OneNote, with general computer literacy • Comfort using virtual meeting platforms, LMS, and MS Teams • Passion for DRG auditing and teamwork, excellence, and collaboration

🏖️ Benefits

• Guidance/coaching through a mentoring program, with junior-level employees assigned a senior-level professional advisor • Opportunities to work closely with experienced healthcare consultants • Professional growth and development opportunities • Up to 10% annual travel for team meetings and limited client onsite engagements

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