Clinical Validation Audit Trainer

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

📋 Description

• Provide educational experiences for both newly hired and experienced CVA coders.

• Utilize clinical and DRG knowledge for training focused on inpatient DRG validation and coding accuracy.

• Evaluate clinical DRG audit results for accuracy and consistency.

• Leverage audit results to enhance training, coaching, and remediation efforts.

• Guide and mentor Clinical DRG Auditors.

• Assess audit patterns to pinpoint learning deficiencies or referral requirements.

• Conduct root-cause analysis on errors found in audits.

• Convert audit results into practical training and performance support strategies.

• Employ industry standards and EXL proprietary tools for DRG validation training.

• Create training materials and communications that document audit scenarios, findings, and clinical justifications.

• Suggest enhancements for training and processes.

• Inform peers, auditors, and management about training needs, trends, and advancements.

• Adhere to company compliance, information security, and regulatory standards.

• Execute additional responsibilities as assigned.

⛳️ Requirements

• Must possess a Registered Nurse license and have an associate or bachelor's degree.

• A minimum of 5 years of experience in acute care nursing is required.

• At least 2 years of experience in facilitating training delivery is essential.

• Previous experience in clinical or coding validation audits is preferred.

• Experience in DRG retrospective overpayment identification audits is a plus.

• Prior experience in readmission (PPR) auditing is preferred.

• Preferred coding credentials include CCS, RHIA, or RHIT.

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

• Ability to clarify complex coding guidelines and audit concepts effectively.

• Familiarity with clinical criteria documentation requirements to support code assignments.

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

• Strong skills in Excel, Word, and OneNote.

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

• Capability to work remotely during EXL's core business hours.

• Excellent analytical, organizational, time-management, written, verbal communication, and attention-to-detail skills.

🏝️ Benefits

• Enjoy 100% remote work from home.

• Opportunity for up to 10% annual travel for team meetings and limited on-site client engagements.

• Access to a mentoring program with support and coaching from senior professionals.

• Opportunities to gain insights from seasoned healthcare consultants.

• Professional and personal growth and development opportunities available.

• Work in an innovative, fast-paced environment.