Clinical Validation Audit Trainer

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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 and impactful learning experiences to new hire and tenured CVA coders • Apply clinical and DRG expertise to support training and education related to inpatient DRG validation and coding accuracy • Review clinical DRG audit outcomes to assess consistency and accuracy, informing training, coaching, and remediation efforts • Mentor and coach Clinical DRG Auditors through targeted education, feedback, and knowledge reinforcement • Analyze audit trends and identify learning gaps or referral needs for additional DRG coding education or review • Perform root cause analysis on audit errors and translate findings into actionable training and performance support • Utilize 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 with peers, auditors, and management regarding training needs, trends, and progress • Perform responsibilities in accordance with 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 • Skill in instructor-led, virtual, and blended training for adult learners • Ability to explain complex coding guidelines and audit concepts clearly • Knowledge of clinical criteria documentation requirements supporting code assignments • Experience with DRG encoder tools: Solventum/3M, TruBridge, and Webstrat • Ability to work independently remotely during EXL core business hours • Proficiency in Excel, Word, and OneNote • General computer literacy • Comfort with virtual meeting platforms, LMS, and MS Teams • Strong written and verbal communication, analytical, organizational, time-management, prioritization, and attention-to-detail skills • Preferred or advantageous: prior clinical or coding validation audit experience; DRG retrospective overpayment identification auditing; readmission (PPR) auditing; CCS, RHIA, or RHIT coding credentials

🏖️ Benefits

• Up to 10% annual travel for team meetings and limited client onsite engagements • Opportunity to work closely with highly experienced, world class Healthcare consultants • Learning opportunities across aspects of clients’ businesses • Guidance/coaching through EXL’s mentoring program • Senior-level professional advisor assigned to every junior-level employee • Opportunities for further growth and development within EXL Health and beyond