Quality Analyst IV - Clinical Validation Auditor (CVA), Healthcare

This is a remote office opportunity. The Quality Analyst oversees work performed by the Clinical CVA auditors to ensure that EXL’s standard of accuracy is met. The analyst undertakes a quality review of random and targeted clinical CVA audits.

A brief coding/auditing assessment may be included as part of the interview process

Estimated salary range is $60,000 to $95,000 plus bonus

For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits

• Apply clinical judgment for DRG audits to ensure accuracy of inpatient DRG coding
• Responsible for reviewing the accuracy and consistency of clinical DRG auditing auditors to ensure audits are appropriately marked for findings and no findings
• Mentor Clinical DRG auditors
• Recommend process changes to improve quality and performance
• Communicate with peers and management
• Provide root cause analysis on errors
• Perform other duties as assigned
• Conduct all job functions and responsibilities in accordance with all company Compliance, Information Security and Regulatory policies, procedures and programs
• Current Registered Nurse license
• 5 plus years experience working with clinical validation audits

Knowledge and Skills

• Superior auditing and monitoring skills
• Ability to mentor and instruct
• Excellent decision making skills and sound judgment
• Thorough understanding of medical terminology and human physiology
• Strong technical knowledge and ability to learn new systems quickly
• Excellent oral/presentation and written communication skills
• Ability to complete tasks efficiently and resolve problems within set timelines
• Strong organizational skills and attention to detail
• Ability to work in a team environment and independently as needed
• Demonstrated flexibility and adaptability
• Must be able to work under deadlines. Must be able to utilize independent decision-making skills in a wide variety of situations
• Requires a high degree of accuracy in the performance of varied responsibilities.
• Personal computer skills required. Must be self-motivated to complete work in a timely manner to meet deadlines
• Strong interpersonal skills required

The posted base salary range is the hiring base salary range for this role. Final offers are based on several factors, including: the candidate's skills and experience, internal pay equity, work location, market conditions for the role, and the specific scope and responsibilities of the position.