RemoteOther

Quality Analyst - Clinical Validation Auditor (CVA), Healthcare

EXLUnited States🇺🇸United States

Quick overview

SeniorityMid Senior

Work modeRemote

LocationUnited States

AuditingComplianceMedical TerminologyRoot Cause Analysis

Job description

This is a remote office opportunity. The Quality Analyst oversees work performed by the Clinical CVA auditors to ensure that EXL’s standard of accuracy is met. The analyst undertakes a quality review of random and targeted clinical CVA audits.

A brief coding/auditing assessment may be included as part of the interview process

Estimated salary range is $85,000 to $110,000

For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits

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

Current Registered Nurse license

5 plus years experience working with clinical validation audits

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.