DRG / IRF Auditor

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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

• Conduct comprehensive IRF payment integrity audits using various documents. • Validate IRF-PAI completion and supporting documentation. • Identify documentation, coding, and reimbursement discrepancies. • Review client payment methodology and contracting requirements. • Craft clear, concise audit findings with rationale and financial impact.

🎯 Requirements

• Minimum High School Diploma required; higher education preferred. • CCS, RHIA, RHIT, CIC, or CPC credential preferred; multiple credentials strongly preferred. • 4+ years of inpatient facility coding, auditing, payment integrity, or reimbursement review experience. • Strong understanding of ICD-10-CM/PCS, inpatient facility claim review, medical record abstraction, and payer reimbursement methodologies. • Proficient in Excel, Word, OneNote, and general computer literacy; experience with audit workflow tools and encoder/reference tools preferred.

🏖️ Benefits

• Health insurance • Dental insurance • Vision insurance • 401(k) options • Flexible work arrangements • Mentorship and career development programs • Paid time off