EXL
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Quality Analyst IV, Diagnosis-Related Group (DRG), Healthcare
Location
United States
Posted
96 days ago
Salary
$70K - $93K / year
Seniority
Senior
Professional Certificate5 yrs expEnglish
Job Description
• Apply clinical judgment for DRG audits to ensure accuracy of inpatient DRG coding
• Responsible for reviewing the accuracy and consistency of clinical DRG auditing auditors to ensure audits are appropriately marked for findings and no findings
• Mentor Clinical DRG auditors
• Recommend process changes to improve quality and performance
• Communicate with peers and management
• Provide root cause analysis on errors
• Perform other duties as assigned
• Conduct all job functions and responsibilities in accordance with all company Compliance, Information Security and Regulatory policies, procedures and programs
Job Requirements
- Current Registered Nurse license
- Minimum 5 years experience working with clinical validation audits
- Superior auditing and monitoring skills
- Ability to mentor and instruct
- Excellent decision making skills and sound judgment
- Thorough understanding of medical terminology and human physiology
- Strong technical knowledge and ability to learn new systems quickly
- Excellent oral/presentation and written communication skills
- Ability to complete tasks efficiently and resolve problems within set timelines
- Strong organizational skills and attention to detail
- Ability to work in a team environment and independently as needed
- Demonstrated flexibility and adaptability
- Must be able to work under deadlines. Must be able to utilize independent decision-making skills in a wide variety of situations
- Requires a high degree of accuracy in the performance of varied responsibilities.
- Personal computer skills required. Must be self-motivated to complete work in a timely manner to meet deadlines
- Strong interpersonal skills required
Benefits
- For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits
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