Clinical Validation Auditor III

EXL

Clinical Validation Auditor reviewing inpatient medical records and DRG codes for EXL, a healthcare analytics company. Identifying coding inaccuracies and potential overpayments remotely across the United States.

Posted 8/12/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $70,000 - $80,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in reviewing inpatient medical records for DRG coding accuracy, applying clinical knowledge to identify discrepancies, and documenting findings professionally. Proficient in using industry tools and maintaining compliance with clinical guidelines and DRG rules.

Highest-signal resume keywords

Registered Nurse (RN)DRG AuditsCCS CertificationClinical DocumentationExcel Proficiency

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

DRG CodingClinical KnowledgeCoding ValidationInpatient Medical Record ReviewDocumentation Skills

Soft Skills

Time ManagementProfessional CommunicationTeam CollaborationIndependent Work

Tools & Technologies

3MWebstratExcelWordOneNote

Certifications & Qualifications

Registered Nurse (RN)CCSRHIARHIT

Industry Keywords

Acute Care ExperienceReadmission ReviewsClinical GuidelinesDRG RulesAudit Decisions

About the role

Key responsibilities & impact

Review inpatient medical records to verify that DRG codes are supported by the documentation
Apply clinical and coding knowledge to identify inaccuracies and potential overpayments
Document findings clearly and professionally, including the rationale for review decisions
Use industry tools such as 3M or Webstrat to support audit decisions
Work independently while meeting productivity and quality goals
Stay current with clinical guidelines, DRG rules, and industry trends

Requirements

What you’ll need

Bachelor’s Degree
Registered Nurse (RN) with an active license
5+ years of acute care experience, preferably in a hospital setting
Experience in DRG audits or coding validation is a plus
CCS, RHIA, or RHIT certifications are a plus
Knowledge of readmission reviews (PPR) is a plus
Ability to explain clinical decisions clearly and professionally
Ability to manage time effectively and stay focused while working remotely
Comfort using Excel, Word, and OneNote
Ability to work as part of a supportive, high-performing team
A brief coding/auditing assessment may be included in the interview process

Benefits

Comp & perks

Fully remote work / work-from-home flexibility
Supportive, collaborative culture
Opportunity to grow in healthcare analytics
Training on industry tools such as 3M or Webstrat if needed