Quality Analyst, Trainer – Home Health

🔥 14 hours ago

🇺🇸 United States – Remote

💵 $60.1k - $98.7k / year

⏰ Full Time

🟠 Senior

🔴 Lead

🧐 Analyst

👻 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.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

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

• Oversee work performed by the home health clinical audit program to ensure EXL’s accuracy standards are met • Review random and targeted clinical coding audits • Consult with clinical auditors, clinicians, and managers to enhance audit accuracy and completeness • Develop audit feedback sessions for all staff based on routine internal audits • Identify general training trends and requirements • Review clinical auditors’ accuracy and consistency to ensure audits are appropriately marked for findings and no findings • Assist in mentoring clinical auditors • Recommend process changes to improve quality and performance • Provide root cause analysis on errors • Update training and user manuals • Communicate with peers and management • Achieve productivity and quality goals • Participate in continuous improvement and education activities • Attend assigned or self-initiated training and monitor CMS, OIG, and other relevant publications • Perform other duties as assigned

🎯 Requirements

• Registered Nurse with a license in good standing in the state that you reside • 7 years home health experience • Previous auditing experience • OASIS certification and/or coding certification preferred but not mandatory • Experience, or equivalent, coding or auditing Home Health OASIS and non-OASIS claims • Ability to review SOC/ROC/Recert assessments for appropriateness, completeness, and compliance with federal and state regulations and organization policy • Ability to ensure appropriate ICD-10 coding and sequencing related to the patient’s medical condition • Knowledge of CMS/Chapter 7 Home Health Coverage Guidelines, National Coverage Guidelines, and HH PPS Reimbursement • Ability to pinpoint, extract, and use record information to cite issues related to overpayment • Superior clinical auditing and monitoring skills • Excellent decision-making skills and sound judgement • Thorough understanding of medical terminology and human physiology • Strong technical knowledge and ability to learn new systems quickly • Excellent verbal and written communication skills • Ability to mentor and instruct through audits • Strong organizational skills and high attention to detail • Demonstrated flexibility and adaptability • Ability to work in a team environment and independently as needed • Working knowledge of Microsoft Excel

🏖️ Benefits

• Remote work flexibility • Up to 10% annual travel for team meetings and limited client onsite engagements • Opportunities for growth and mentorship through a structured coaching program • Collaborative culture where ideas and insights are valued • Real opportunities for advancement • Fast-paced, innovative environment with a team of sharp, driven professionals