Outpatient Auditor III
EXL
Home Health Auditor III
EXL
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteSalary
💰 $70,000 - $80,000 per year
Job Level
Mid-LevelSenior
About the role
- Audit Home Health medical records to validate or revise billed services based on CMS guidelines.
- Apply clinical judgment and coding expertise to identify overpayments and ensure proper reimbursement.
- Document audit findings with clarity, professionalism, and precision using OASIS, ICD-10 CM, and CMS Home Health guidelines.
- Utilize industry-leading tools like Decision Health, Webstrat, and proprietary EXL platforms to complete your work efficiently.
- Identify audit trends and help drive improvements that benefit both providers and patients.
- Stay current on the latest clinical and reimbursement guidelines and deliver work that meets or exceeds productivity and quality benchmarks.
Requirements
- LPN or Registered Nurse (Associate’s or Bachelor’s degree preferred).
- 3+ years of acute care nursing experience, with strong consideration for candidates holding OASIS or Coding certifications.
- Prior experience in Home Health auditing is essential.
- Deep knowledge of PDGM and PPS payment methodologies.
- Proficiency in auditing and coding tools (Decision Health, ICD-10, Webstrat).
- Strong command of Microsoft Office, including Excel, Word, and OneNote.
- Exceptional time management, attention to detail, and independent work ethic.
- Clear and confident communicator – both in writing and verbally.
- Passion for improving healthcare through teamwork, collaboration, and continuous learning.
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.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
OASISICD-10 CMCMS guidelinesauditingcodingPDGMPPSclinical judgmentreimbursementattention to detail
Soft skills
time managementindependent work ethicclear communicationconfident communicationteamworkcollaborationcontinuous learning
Certifications
LPNRegistered NurseOASIS certificationCoding certification
