DRG Quality Analyst IV – Healthcare

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

📋 Description

• Utilize clinical judgment during DRG audits to ensure the precision of inpatient DRG coding.

• Assess the accuracy and consistency of Clinical DRG auditors' work to confirm that audits are correctly labeled for both findings and lack of findings.

• Provide mentorship to Clinical DRG auditors.

• Suggest process enhancements to boost quality and performance.

• Engage in communication with peers and management.

• Conduct root cause analyses on errors.

• Carry out additional duties as assigned.

• Perform all job functions and responsibilities in alignment with company Compliance, Information Security, and Regulatory policies, procedures, and programs.

⛳️ Requirements

• A Bachelor’s Degree is required.

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

• An active Coding Certification such as CIC, CCS, CPC, RHIT, or RHIA is required.

• Exceptional auditing and monitoring abilities.

• Capability to mentor and instruct others effectively.

• Strong decision-making skills and sound judgment.

• Comprehensive understanding of medical terminology and human physiology.

• Advanced technical knowledge with a quick learning ability for new systems.

• Excellent oral, presentation, and written communication skills.

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

• Strong organizational skills with keen attention to detail.

• Ability to collaborate in a team environment as well as work independently when required.

• Demonstrated flexibility and adaptability.

• Must be capable of working under deadlines and exercising independent judgment in a variety of situations.

• A high degree of accuracy is required in diverse responsibilities.

• Proficient personal computer skills are essential.

• Must be self-motivated to complete assignments promptly to meet deadlines.

• Strong interpersonal skills are a must.

🏝️ Benefits

• Benefits information is available at https://www.exlservice.com/us-careers-and-benefits.

• Remote office/work-from-home opportunity.