High Cost Drug Auditor
EXL
full-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $60,000 - $90,000 per year
About the role
- In this fully remote position as an HCD Auditor you will apply your expert knowledge of billing HCD claims to perform extensive audit reviews.
- You will utilize HCPCS codes, medical record review, industry and EXL proprietary tools in the audit process.
- Write professional communications documenting audit findings and supporting rationales.
- You will also apply your extensive industry knowledge to identify audit trends and opportunities.
Requirements
- Expert in HCPCS codes with advanced knowledge of medical terminology.
- Prefer experience with encoder tools and industry systems (FACETS, NASCO, Encoder Pro, TrueCode, 3M, Webstrat, Pricers).
- Works independently in a remote environment and delivers exceptional results during EXL core business hours.
- Possesses excellent time management and work prioritization skills.
- Takes ownership of problem solving.
- Demonstrates excellent written and verbal communication skills, strong analytical skills, and attention to detail.
- Intermediate skills in Word and basic computer literacy.
- Intermediate skills in Excel including comfort working with charts, graphs and percentages.
- Basic math skills with ability to do conversion calculations.
- Passionate about Auditing with a desire to work in an environment thriving on teamwork, excellence, collaboration, inclusiveness, and support.
- Minimum High School Diploma
- 3+ years of claims processing or HCD medical billing experience with expert knowledge HCPCS codes.
- Must have prior experience reading and interpreting contract language and fee schedules and medical record review.
- Prefer Certified Pharmacy Technician or one or more of the following credentials: RHIA or CPC; preference given to those with multiple credentials.
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 & Tools
HCPCS codesmedical terminologyclaims processingmedical billingaudit reviewscontract language interpretationfee schedulesmedical record reviewExcelWord
Soft Skills
time managementwork prioritizationproblem solvingwritten communicationverbal communicationanalytical skillsattention to detailteamworkcollaborationinclusiveness
Certifications
Certified Pharmacy TechnicianRHIACPC