Jobs at EXL

Audits outpatient and multispecialty surgery coding for quality, accuracy, compliance, and productivity. The role follows SOPs and project protocols, maintains productivity and clarification logs, identifies trends, escalates issues, responds promptly to management, and supports team compliance with HIPAA and OIG requirements. Candidates must hold CPC certification, have at least three years of relevant coding experience, strong communication skills, computer proficiency, and reliable broadband for remote work.

Conducts secondary quality audits of inpatient medical records and DRG assignments. Validates diagnoses, procedures, POA indicators, discharge dispositions, and coding compliance with IPPS, ICD-10-CM/PCS, HIPAA, payer, and client requirements. Identifies error trends, meets quality SLAs, maintains audit trackers, and reports findings using 3M software, NLP tools, and Microsoft Office. Requires certified inpatient coding expertise, strong communication, and adherence to SOPs and project protocols.

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

Audits outpatient and multispecialty surgery coding for quality, productivity, SOP, HIPAA, and OIG compliance. Maintains productivity and clarification logs, meets production targets, follows project protocols, escalates issues, identifies trends, resolves coding questions, and communicates promptly with managers. The role requires CPC or CPMA certification, substantial post-certification coding experience, and expertise in outpatient, IVR, and general surgery coding.

Audits multi-specialty outpatient surgery, ED facility, and inpatient E&M coding for quality, productivity, and compliance. Maintains daily productivity and clarification logs, follows SOPs and project protocols, escalates issues, identifies trends, communicates with managers, and supports team compliance with HIPAA and OIG requirements. The role requires strong anatomical knowledge, analytical and communication skills, CPC or CPMA certification, and at least three years of relevant coding experience.

Manage insurance claim follow-ups and collections, ensure daily productivity and quality targets, resolve patient billing queries, post payments and adjustments, maintain HIPAA compliance, and use practice management/EMR systems to prevent revenue loss.

Perform comprehensive inpatient medical record reviews to validate ICD-10-CM/PCS codes and DRG assignments per IPPS/CMS rules. Identify documentation gaps, collaborate with clinical teams, conduct routine coding quality audits, analyze findings, mentor coding staff, deliver education to coders and CDI specialists, and ensure compliance with HIPAA/OIG and organizational SOPs.

Perform in-depth quality reviews of inpatient medical records to validate DRG coding, POA, procedures, discharge disposition and compliance with IPPS methodology. Mentor and train DRG auditors, provide feedback and education to coding staff, meet quality SLAs, track error trends, follow SOPs, maintain HIPAA compliance, and update monitoring trackers.

Perform claims adjudication and data mining for healthcare payer accounts. Calculate payment determinations without system support, meet quality and TAT targets, produce reports, ensure compliance, communicate with stakeholders, and work independently on assigned inventory.

Manage subrogation files and pursue claim recoveries by investigating paid claims, reviewing accident and medical documents, notifying involved parties, negotiating settlements, communicating with attorneys, insurers, and hospitals, maintaining accurate documentation, and adhering to settlement authority, productivity, quality, and confidentiality standards.

Handles insurance account receivable follow-up for US healthcare claims, including contacting insurers, resolving unpaid claims, reviewing patient insurance information, prioritizing aging accounts, and preventing revenue loss. Maintains HIPAA confidentiality, addresses patient billing queries, updates account information, posts cash, records contractual adjustments, escalates complex collection issues, and meets individual productivity and quality targets.

Audits outpatient and multispecialty surgery coding for quality, productivity, SOP, HIPAA, and OIG compliance. The role identifies trends, escalates issues, maintains productivity and clarification logs, meets production targets, communicates with managers, and supports team compliance. Candidates need CPC or CPMA certification, at least three years of surgery coding experience, strong communication skills, computer proficiency, and reliable broadband for telecommuting.

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

Audits outpatient and multispecialty surgery coding for quality, productivity, and compliance. Follows SOPs and project protocols, identifies trends, escalates issues, maintains productivity and clarification logs, and responds promptly to management. Ensures team adherence to HIPAA and OIG requirements while meeting quality and production targets. The role requires CPC or CPMA certification, coding experience in outpatient surgery, strong communication skills, computer proficiency, and reliable broadband for full-time remote work.

Perform high-quality coding audits following SOPs and project protocols to meet quality and production targets. Maintain productivity and clarification logs, escalate issues, ensure HIPAA/OIG compliance, answer manager communications promptly, and support team problem-solving.

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

Perform accurate coding audits per SOP to meet quality and production targets for outpatient surgery coding. Maintain logs, escalate trends/issues, ensure team compliance with HIPAA/OIG, respond to management, and support auditing and denial management processes.

Perform comprehensive inpatient record reviews to validate ICD-10-CM/PCS codes, DRG assignments, and IPPS compliance; identify documentation gaps and work with clinical/CDI teams for clarification; mentor and educate coding staff; conduct routine audits, analyze findings, prepare reports, and ensure adherence to CMS, HIPAA, and OIG guidelines using 3M/NLP tools and Microsoft Office.

Lead product vision, strategy, and full lifecycle for healthcare Fraud, Waste, and Abuse detection products. Gather stakeholder requirements, document specifications, drive agile sprint delivery, and use data-driven insights and analytics to iterate and improve payment integrity platforms.

Reviews inpatient medical records to validate ICD-10-CM/PCS codes, DRG assignments, diagnoses, procedures, POA indicators, and discharge dispositions. Conducts coding audits, identifies documentation gaps, collaborates with clinical teams, mentors coding staff and CDI specialists, analyzes audit trends, prepares reports, and ensures compliance with CMS, IPPS, HIPAA, OIG, and coding standards.