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Auditor III, Healthcare

AuditorAuditorFull TimeRemoteSeniorTeam 10,001+H1B No SponsorCompany Site LinkedIn

Location

United States

Posted

140 days ago

Salary

$70K - $90K / year

Seniority

Senior

Bachelor Degree4 yrs expEnglish

Job Description

• Conduct comprehensive MS-DRG and APR-DRG coding reviews to ensure accuracy in DRG assignment and reimbursement. • Apply expert knowledge of coding guidelines and utilize industry-leading tools to maximize overpayment identifications. • Craft clear, concise, and well-supported audit findings, backed by AHA Coding Clinic Guidelines and ICD-10-CM/PCS regulations. • Utilize advanced DRG encoder tools (such as 3M, Webstrat) to drive efficiency and accuracy in audits. • Meet or exceed EXL’s quality and productivity standards, including strong uphold rates for appeals. • Stay ahead of industry trends, coding updates, and compliance regulations to maintain expert-level knowledge. • Adhere to HIPAA and EXL policies and procedures to ensure data security and regulatory compliance.

Job Requirements

Minimum High School Diploma (Higher education preferred).
CCS, RHIA, or RHIT credential (Multiple credentials preferred).
4+ years of MS-DRG/APR-DRG coding experience with a deep understanding of AHA Coding Guidelines and DRG reimbursement methodologies.
Prior experience in DRG retrospective overpayment identification auditing is highly desirable.
Strong proficiency with DRG encoder tools (3M, Webstrat).

Benefits

A fast-paced, innovative environment with a team of industry-leading experts.
Hands-on experience with top-tier clients in the healthcare industry.
Mentorship and career development programs to help you grow professionally.
A strong culture of collaboration, support, and inclusivity.
Competitive benefits package, including healthcare, vision, dental, and 401(k) options.