JOB DESCRIPTION
This role offersa fully remote work experiencea witha possible 10%travel per year. The rest of the time, you'll enjoy the flexibility of working from your home office.
Salary Range: $70,000 6 $110,000a (based on experience, skills, and qualifications)
Location: 100% Remote (U.S.-based)
Up to 10% annual travela (for team meetings and limited client onsite engagements.)
A brief coding/auditing assessment may be included as part of the interview process.
For more information on benefits and what we offer please visit us atahttps://www.exlservice.com/us-careers-and-benefits
JOB RESPONSIBILITIES
7 Conductacomprehensive MS-DRG and APR-DRG readmission reviewsato ensure accuracy in DRG assignment and reimbursement.
7 Applyaexpert knowledge of coding guidelinesaand utilizeaindustry-leading toolsato maximize overpayment identifications.
7 Craftaclear, concise, and well-supported audit findings, backed byaAHA Coding Clinic Guidelinesaand ICD-10-CM/PCS regulations.
7 Utilize advanced DRG encoder tools (such asa3M, Webstrat) to drive efficiency and accuracy in audits.
7 Meet or exceedaEXL9s quality and productivity standards, including strong uphold rates for appeals.
7 Stay ahead ofaindustry trends, coding updates, and compliance regulationsato maintain expert-level knowledge.
7 Adhere toaHIPAA and EXL policies and proceduresato ensure data security and regulatory compliance.
JOB QUALIFICATIONS
Education & Credentials:
- MinimumaHigh School Diplomaa(Higher education preferred).
- CCS, RHIA, or RHITacredential (Multiple credentials preferred).
Experience & Expertise:
- 4+ years of MS-DRG/APR-DRG coding experienceawith a deep understanding ofaAHA Coding GuidelinesaandaDRG reimbursement methodologies.
- Prior experience inaDRG readmission retrospective overpayment identification auditingais highly desirable.
