Clinical Validation Auditor – Auditor III

EXL

Clinical Validation Auditor reviewing medical records and validating codes for EXL. Fully remote position leveraging nursing expertise in coding accuracy and compliance.

Posted 7/28/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $70,000 - $80,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in DRG coding and auditing, with a strong background in clinical guidelines and documentation accuracy. Proficient in using industry tools to support coding decisions while maintaining high productivity and quality standards.

Highest-signal resume keywords

Registered Nurse (RN)DRG AuditsClinical KnowledgeCCS Certification5+ Years Acute Care Experience

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

DRG CodingCoding ValidationClinical Documentation ReviewInpatient Medical Record ReviewReadmission Reviews

Soft Skills

Clear CommunicationIndependent Work

Tools & Technologies

3MWebstrat

Certifications & Qualifications

CCSRHIARHIT

Industry Keywords

Diagnosis-Related Group (DRG)Clinical GuidelinesAcute CareOverpayment IdentificationProductivity Goals

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 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

Flexible remote work
A culture of support
Opportunity to grow in healthcare analytics