Teams at EXL

Audit inpatient (IP) DRG records to meet quality and production targets. Follow SOPs and project protocols, complete audits accurately, update productivity and clarification logs daily, escalate and identify trends, coordinate with Manager/TL, ensure team compliance with HIPAA and OIG, and maintain timely email communication. Requires strong Excel skills, flexibility, and good communication.

Perform timely audits of medical records and insurance claims to verify documentation, coding (ICD/CPT/HCPCS), and medical necessity. Identify and resolve discrepancies, collaborate with providers/coders, ensure HIPAA/CMS compliance, produce audit reports, support internal QA, and meet quality and production targets.

Lead quality audits of coded medical records to ensure accurate CPT, ICD-10-CM, and HCPCS coding and payer compliance. Identify errors and trends, provide feedback, support training and process improvements, enforce HIPAA/OIG compliance, and manage and motivate a coding quality team.