Clinical Validation Audit Trainer

This is a fully remote position, open to applicants in United States.

📋 Description

• Provide engaging and impactful learning experiences for both new hire and experienced CVA coders.

• Leverage clinical and DRG expertise to enhance training and education focused on inpatient DRG validation and coding accuracy.

• Analyze clinical DRG audit results to evaluate consistency and accuracy, which will inform training, coaching, and remediation initiatives.

• Guide and mentor Clinical DRG Auditors through focused education, constructive feedback, and reinforcement of knowledge.

• Examine audit trends to pinpoint learning gaps or identify needs for further DRG coding education or reviews.

• Conduct root cause analysis on audit discrepancies and convert findings into actionable training and performance support measures.

• Employ industry standards and proprietary EXL tools to facilitate DRG validation training and education.

• Create training communication and materials that document audit scenarios, outcomes, and clinical justifications.

• Suggest enhancements to training and processes to improve audit quality and performance results.

• Liaise with colleagues, auditors, and management regarding training requirements, trends, and advancements.

• Execute responsibilities in alignment with company compliance, information security, and regulatory standards.

• Undertake additional duties as assigned.

⛳️ Requirements

• Registered Nurse.

• Associate or bachelor's degree.

• Over 5 years of experience in acute care nursing.

• At least 2 years of experience in delivering training.

• Proficiency in instructor-led, virtual, and blended training for adult learners.

• Capability to clearly articulate complex coding guidelines and audit concepts.

• Understanding of clinical criteria documentation requirements that support code assignments.

• Familiarity with DRG encoder tools such as Solventum/3M, TruBridge, and Webstrat.

• Ability to work independently in a remote setting during EXL's core business hours.

• Proficient in Excel, Word, and OneNote.

• General computer literacy.

• Comfortable using virtual meeting platforms, LMS, and MS Teams.

• Strong skills in written and verbal communication, analytical thinking, organization, time management, prioritization, and attention to detail.

• Preferred or advantageous: prior experience in clinical or coding validation audits; auditing for DRG retrospective overpayment identification; readmission (PPR) auditing; CCS, RHIA, or RHIT coding credentials.

🏝️ Benefits

• Up to 10% annual travel for team meetings and limited onsite client engagements.

• Opportunity to collaborate with highly experienced, world-class healthcare consultants.

• Learning opportunities across various facets of clients’ businesses.

• Support and coaching through EXL’s mentoring program.

• A senior-level professional advisor assigned to each junior-level employee.

• Opportunities for further growth and development within EXL Health and beyond.