• Conducts internal and external timely operational, compliance, and financial audits of divisions, departments, providers, and activities of the corporation including evaluation of internal controls. • Identifies, documents, and evaluates business risks. • Documents issues, the causes of those issues, and their effects on the process/function and the corporation. • Drafts recommendations to limit risks and improve processes, functions and activities. • Writes audit reports for corporate executive management that clearly and effectively convey engagement evaluations, conclusions, and recommendations. • Collects and analyzes data to detect deficient controls, duplicated effort, fraud, or non-compliance with laws, regulations, and management policies. • Conducts testing of corrective actions as identified. • Develops detailed reports on each audit conducted. • Reports include a review of findings and an identification of recommendation to correct any deficiencies and methods for improvement to processes. • Examines and evaluates financial and information systems, recommending controls to ensure system reliability and data integrity. • Conducts special audit studies for management, such as those required to discover controls for prevention of fraud. • Prepares reports of findings and recommendations for management. • Assists other auditors in completing their assignments as a means of maximizing audit efficiency and thus reducing lost time and involvement of corporate personnel.

• Develop, direct, plan and evaluate internal audit programs • Audit information system applications to ensure that appropriate controls exist • Evaluate security controls, identifying vulnerabilities, and recommending improvements • Perform IT audit and cybersecurity‑focused consulting engagements • Apply professional IT audit concepts, cybersecurity frameworks, and established technologies • Participate in audit planning, providing insights on technology risks • Attend and conduct walkthroughs with Humana business and technology teams • Identify control weaknesses, cybersecurity vulnerabilities, and misconfigurations • Prepare clear, actionable draft audit issues • Recommend security‑focused improvements and follow through on corrective actions • Collaborate with internal audit team members to align IT audit coverage • Develop communication skills for effective discussion of security findings

• In this fully remote position as an HCD Auditor you will apply your expert knowledge of billing HCD claims to perform extensive audit reviews. • You will utilize HCPCS codes, medical record review, industry and EXL proprietary tools in the audit process. • Write professional communications documenting audit findings and supporting rationales. • You will also apply your extensive industry knowledge to identify audit trends and opportunities.

• Conduct Home Health reviews to verify the accuracy of the billed services based on CMS guidelines. • Apply CMS guidelines during medical record review to ensure services provided are supported. In addition, utilize industry and proprietary tools to maximize overpayment identifications. • Document audit results in a clear, concise, and effective manner using CMS Home Health, Oasis and ICD-10 CM Guidelines. • Utilize proprietary workflow systems and encoder tools (e.g., Decision Health, Webstrat, etc.) efficiently and accurately to make audit determinations, generate audit rationales and move claims through workflow process correctly. • Meet or exceed EXL established program productivity and quality goals, including uphold rate for appeals. • Demonstrate knowledge of and compliance with changes and updates to clinical guidelines, reimbursement trends, and client processes and requirements. • Comply with all EXL policies and procedures including HIPAA and other state and federal regulations.