DRG Quality Analyst IV – Healthcare

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

📋 Description

• Utilize clinical expertise for DRG audits to ensure the precision of inpatient DRG coding.

• Assess the accuracy and consistency of the work performed by clinical DRG auditors and ensure audits are properly classified as having findings or no findings.

• Provide guidance and mentorship to Clinical DRG auditors.

• Suggest process improvements to enhance quality and performance.

• Engage in communication with colleagues and management.

• Conduct root cause analysis on identified errors.

• Execute additional tasks as required.

• Perform all job functions in compliance with company policies regarding Compliance, Information Security, and Regulatory standards.

⛳️ Requirements

• At least 5 years of experience in clinical validation audits.

• Current Coding Certification: CIC, CCS, CPC, RHIT, or RHIA.

• Exceptional auditing and monitoring capabilities.

• Proficiency in mentoring and instructing others.

• Strong decision-making abilities and sound judgment.

• Comprehensive knowledge of medical terminology and human physiology.

• Solid technical expertise with a quick learning curve for new systems.

• Outstanding oral, presentation, and written communication skills.

• Capability to efficiently complete tasks and resolve issues within established timelines.

• Strong organizational skills and meticulous attention to detail.

• Ability to collaborate in a team setting as well as work independently when necessary.

• Proven flexibility and adaptability to changing circumstances.

• Capacity to work under pressure and apply independent decision-making skills.

• High level of accuracy across diverse responsibilities.

• Proficient computer skills.

• Self-driven to complete work promptly and adhere to deadlines.

• Strong interpersonal skills.

🏝️ Benefits

• Opportunity to work from home or remotely.

• Benefits details available on EXL’s US Careers and Benefits page.