High Cost Drug Auditor III

Job not on LinkedIn

🕒 July 9

🇺🇸 United States – Remote

💵 $55k - $70k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔎 Auditor

👻 Ghost score 4%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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

• 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