Clinical Validation Auditor, Auditor III
EXL
full-time
Posted on:
Location Type: Remote
Location: United States
Visit company websiteExplore more
Salary
💰 $70,000 - $80,000 per year
About the role
- Review inpatient medical records to verify that the DRG code makes sense based on the documentation
- Apply clinical and coding knowledge to spot inaccuracies and identify potential overpayments
- Document your findings in clear, professional language that explains the rationale behind your review
- Use industry tools like 3M or Webstrat to support your decisions (training provided)
- Work independently while meeting productivity and quality goals
- Stay up to date with clinical guidelines, DRG rules, and industry trends
Requirements
- Registered Nurse (RN) with an active license
- 5+ years of acute care experience (hospital setting preferred)
- Experience in DRG audits or coding validation is a big plus!
- Bonus points if you have certifications like CCS, RHIA, or RHIT
- Knowledge of readmission reviews (PPR) is also a plus
Benefits
- Remote work
- Opportunities for professional growth
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
DRG codingclinical knowledgecoding validationreadmission reviews
Soft Skills
independent workdocumentationcommunication
Certifications
Registered Nurse (RN)CCSRHIARHIT