JOB DESCRIPTION
This is a remote office opportunity. The DRG Quality Analyst oversees work performed by the Clinical DRG auditors to ensure that EXL’s standard of accuracy is met. The analyst undertakes a quality review of random and targeted clinical DRG audits.
A brief coding/auditing assessment may be included as part of the interview process
Salary Range is: $85k - $110k
JOB RESPONSIBILITIES
- 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 QUALIFICATIONS
- Minimum 5 years of experience working with clinical validation audits
- Active Coding Certification: CIC, CCS, CPC, RHIT, or RHIA
Knowledge and Skills:
- 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
The posted base salary range is the hiring base salary range for this role. Final offers are based on several factors, including: the candidate's skills and experience, internal pay equity, work location, market conditions for the role, and the specific scope and responsibilities of the position.
