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EXL

Clinical Validation Auditor III

EXL

Join EXL as a Clinical Validation Auditor working remotely in the US to ensure accurate medical claims coding and identify billing discrepancies.

Posted 5/16/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $70,000 - $80,000 per yearWebsite

About the role

Key responsibilities & impact
  • Review inpatient medical records to verify that the DRG (Diagnosis-Related Group) 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 (don’t worry—we’ll train you if needed!) to support your decisions.
  • Work independently while meeting productivity and quality goals.
  • Stay up to date with clinical guidelines, DRG rules, and industry trends.

Requirements

What you’ll need
  • 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

Comp & perks
  • Remote work
  • Culture of support
  • Opportunity to grow in healthcare analytics

ATS Keywords

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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
attention to detailindependent workclear communicationprofessional documentation
Certifications
Registered Nurse (RN)CCSRHIARHIT