Outpatient Auditor Manager

🔥 14 hours ago

🇺🇸 United States – Remote

💵 $105k - $115k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔎 Auditor

👻 Ghost score 1%

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

• Lead the execution and continuous improvement of outpatient audit programs • Oversee day-to-day audit operations to meet client SLAs, quality standards, productivity goals, and turnaround requirements • Manage inventory, workflow distribution, aging, and throughput • Provide direct supervision, coaching, feedback, and development for outpatient auditors and team leads • Monitor productivity, quality, and turnaround metrics and implement corrective actions • Ensure audits comply with CMS regulations, NCCI guidelines, payer policies, and coding and billing requirements • Support implementation of new clients, audit opportunities, workflow changes, and system enhancements • Conduct quality reviews and identify trends requiring education, clarification, or process improvement • Develop and deliver training on outpatient coding, reimbursement, audit methodologies, and payer requirements • Identify operational risks, escalate issues, and support timely resolution • Prepare and present reports on productivity, quality, inventory, aging, and audit outcomes • Support client meetings, reporting requests, and audit strategy discussions • Assist with workforce planning, hiring, onboarding, performance management, and talent development

🎯 Requirements

• Bachelor's Degree • Five to eight years of experience in outpatient coding, auditing, payment integrity, revenue cycle, or healthcare reimbursement operations • RHIT, RHIA, CCS, CPC, COC, or equivalent coding credential preferred • Strong knowledge of CPT, HCPCS, revenue codes, modifier usage, NCCI edits, APC reimbursement methodologies, and outpatient billing guidelines • Knowledge of Medicare, Medicaid, and commercial payer policies • Prior experience leading teams or serving in a supervisory capacity within a production-driven environment • Experience supporting healthcare audit operations, payment integrity programs, or claims review functions • Strong analytical and problem-solving skills • Ability to interpret clinical documentation, coding guidelines, and reimbursement requirements • Proficiency with Microsoft Office applications and healthcare audit or reporting systems • Ability to manage audit workflows and team performance to meet operational targets • Ability to analyze data, identify risks and trends, and develop practical action plans • Strong leadership, coaching, and team development skills • Effective collaboration across clinical, coding, operational, client-facing, and technical teams • Ability to support process improvements, workflow enhancements, and program implementations • Strong organizational, prioritization, and time management skills • Ability to build relationships and maintain positive team and client interactions • Ability to complete a brief coding/auditing assessment as part of the interview process

🏖️ Benefits

• Healthcare, vision, and dental benefits • 401(k) options • Professional development • Collaboration, support, and inclusion culture • Up to 10% annual travel for team meetings and limited client onsite engagements • Fast-paced, innovative environment with industry-leading experts • Hands-on experience supporting leading healthcare clients