Jobs at EXL

Perform and complete inpatient DRG audits per SOP, meet quality and production targets, follow project protocols, escalate issues, update daily logs, consult managers for clarifications, ensure team HIPAA and OIG compliance, and maintain prompt communication and accurate records.

Perform high-volume outbound calls to US insurers, providers, and TPAs to resolve denied or pending claims, document interactions, correct denials, meet productivity and quality targets, and ensure HIPAA/OIG compliance while coordinating with internal teams and updating management on claim status.

Reviews medical claims against patient records to validate diagnoses, procedures, documentation, coding, and billed services. Identifies discrepancies, compliance issues, documentation gaps, and revenue leakage, then prepares audit findings and corrective recommendations. Collaborates with coding, billing, and provider teams, monitors recurring trends, supports quality assurance, follows CMS and payer requirements, and meets audit accuracy and productivity targets.

Handle US healthcare accounts receivable calling insurance companies to resolve claims, verify insurance details, post cash and adjustments, meet daily productivity targets, follow HIPAA/confidentiality rules, escalate difficult cases, and respond to patient billing queries during assigned night shift.

Audits outpatient and multispecialty surgery coding for quality, productivity, compliance, and protocol adherence. Maintains productivity and clarification logs, escalates issues, identifies trends, responds promptly to management, and supports team compliance with HIPAA and OIG requirements. The role requires CPC or CPMA certification, at least three years of coding experience, strong communication, problem-solving skills, and reliable broadband for telecommuting.

Perform high-quality coding audits for outpatient surgery and multi-specialty cases, follow SOPs and project protocols, meet quality and production targets, update logs daily, escalate trends/issues, ensure HIPAA/OIG compliance, and communicate promptly with managers.

Reviews medical claims against patient records to validate diagnoses, procedures, documentation, coding, billing accuracy, and compliance with CMS, payer, and regulatory requirements. Identifies discrepancies, revenue leakage, and recurring audit issues; prepares findings and corrective recommendations; collaborates with coding, billing, and provider teams; supports quality assurance, process improvement, regulatory updates, and productivity targets.

Audit and resolve coding, payment integrity, and appeals queues by reviewing medical records, validating CPT/HCPCS/ICD-10-CM codes, applying NCCI/CMS and payer guidelines, and researching disputes. Maintain productivity, quality, SLA targets, document findings, participate in audits, escalate complex cases, recommend process improvements, and ensure HIPAA/OIG compliance.

Audits outpatient and multispecialty surgery coding for quality, accuracy, compliance, and productivity targets. Follows SOPs, project protocols, and HIPAA/OIG requirements; maintains productivity and clarification logs; escalates issues, identifies trends, resolves coding questions, and communicates promptly with managers. Requires CPC or CPMA certification, at least three years of post-certification coding experience, surgery coding expertise, and strong written and oral communication skills.

Leads enterprise technical delivery and software engineering strategy for US healthcare and payer analytics solutions. Oversees large-scale engineering teams, project lifecycles, budgets, quality, compliance, interoperability, and continuous improvement. Develops delivery roadmaps, manages risks and resources, mentors leaders, and partners with executives, clients, vendors, sales, marketing, and regulatory stakeholders. Requires deep healthcare domain knowledge, strong technical architecture expertise, and experience scaling organizations and converting opportunities into revenue.

Audits medical claims against patient records to validate diagnoses, procedures, documentation, coding, billed services, and level of care. Ensures compliance with CMS guidelines, payer policies, and regulations; identifies discrepancies, billing errors, documentation gaps, and revenue leakage. Produces audit reports, recommends corrective actions, collaborates with coding, billing, and provider teams, monitors trends, supports quality assurance, and maintains productivity and accuracy standards.

Audits outpatient and multispecialty surgery coding for quality, productivity, compliance, and target achievement. Follows SOPs and project protocols, identifies trends, escalates issues, maintains productivity and clarification logs, responds promptly to management, and supports problem-solving. Ensures team adherence to HIPAA and OIG requirements. The role requires CPC or CPMA certification, at least three years of post-certification coding experience, strong communication skills, and reliable broadband for remote work.

Perform accurate CPT and ICD-10-CM coding, analyze denied claims, contact provider offices to resolve denials, document outcomes and update claim status, follow up to maximize reimbursement, adhere to client guidelines, meet quality/productivity benchmarks, and prepare performance reports using Excel and PowerPoint.

Manage healthcare accounts receivable by contacting insurers, resolving unpaid claims, reviewing insurance information, following up on aging accounts, and meeting productivity and quality targets. Handle patient billing inquiries, update account information, post cash, process contractual write-offs, maintain HIPAA confidentiality, and escalate complex collection issues. The role requires full-time overnight work, broadband internet, and adherence to telecommuter policies.

Lead quality audits of coded medical records (CPT, ICD-10-CM, HCPCS), identify coding errors and trends, provide feedback and training, manage and motivate a coding quality team, ensure HIPAA/OIG compliance, handle client queries, support process improvements, and stay current with coding standards and payer rules. Requires certification, nursing license, and specialist IVR coding experience.

Audits inpatient DRG coding for quality, accuracy, productivity, and compliance with SOPs, HIPAA, and OIG requirements. Maintains productivity and clarification logs, meets production targets, follows project protocols, escalates issues, identifies trends, responds promptly to management, and supports team compliance. Uses Microsoft Office, 3M software, and NLP tools.

Conduct secondary quality audits of inpatient medical records and DRG assignments. Validate diagnoses, procedures, POA indicators, discharge dispositions, and coding accuracy against IPPS, ICD-10-CM/PCS, HIPAA, payer, and client requirements. Track quality metrics, identify error trends, meet SLAs, document findings, escalate issues, and use 3M software, NLP tools, and Microsoft Office for audit reporting.

Audits inpatient DRG coding for quality, accuracy, compliance, and productivity targets. Follows SOPs and project protocols, maintains audit and productivity logs, escalates issues, identifies trends, responds promptly to management, and supports team compliance with HIPAA and OIG requirements. Uses Microsoft Office, 3M software, and NLP tools while coordinating clarifications with managers and team leads.

Audits inpatient DRG coding, ensuring quality, productivity, SOP, HIPAA, and OIG compliance. Maintains productivity and clarification logs, meets production targets, follows project protocols, escalates issues, identifies trends, responds promptly to management, and supports team compliance. Requires strong Excel, communication, flexibility, and knowledge of coding audit tools.

Perform detailed medical coding audits and resolve code edit, payment integrity, PCI, and appeals queues. Validate CPT/HCPCS/ICD-10-CM codes and modifiers, apply CMS/NCCI/payer guidelines, research disputes, maintain productivity and quality targets, log audit activity, participate in audits, recommend process improvements, and ensure HIPAA and OIG compliance.