Quality Analyst IV, Diagnosis-Related Group (DRG), Healthcare
EXL
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteSalary
💰 $70,000 - $93,000 per year
Job Level
Mid-LevelSenior
About the role
- 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
Requirements
- Current Registered Nurse license
- Minimum 5 years experience working with clinical validation audits
- 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
Benefits
- For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
DRG codingclinical validation auditsauditing skillsroot cause analysismedical terminologyhuman physiologydecision makingproblem resolutionaccuracy in performanceprocess improvement
Soft skills
mentoringcommunicationorganizational skillsattention to detailteamworkflexibilityadaptabilityindependent decision-makingtime managementinterpersonal skills
Certifications
Registered Nurse license