Quality Analyst – Skilled Nursing Facility, Patient-Driven Payment Model

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EXL

WebsiteLinkedInAll Job Openings

10,000+ employees

💰 $2M Venture Round on 2015-01

Choosing a digital partner is about more than capabilities — it’s about collaboration and character.

📋 Description

• Conduct quality reviews of completed audits • Ensure compliance with CMS regulations, internal policies client requirements, and audit methodologies • Evaluate the accuracy, consistency, and defensibility of audit determinations • Identify trends and process improvement opportunities • Contribute to overall quality performance and operational excellence

🎯 Requirements

• Registered Nurse, Licensed Practical Nurse, or Licensed Vocational Nurse license in good standing in the state that you reside • 5 plus years’ experience with SNF clinical, MDS 3.0 completion, PDPM reimbursement methodology, quality assurance, auditing, and/or related experience • Advanced knowledge of MDS 3.0 coding guidelines, skilled nursing facility (SNF) levels of care, and PDPM reimbursement • Previous experience/exposure to the billing of HIPPS codes • Experience reviewing audit findings, conducting quality revises, or performing compliance monitoring activities • Experience with: Excel, PowerPoint, Outlook, and Word • Experience with Encoder tools such as 3M • Experience with and expertise with Medicare Local Coverage Determinations (LCD) and National Coverage Determinations (NCD) • Must be detail oriented • Must have excellent verbal and written communication skills • Must be self-directed and able to work with minimum oversight

🏖️ Benefits

• For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits