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EXL

We make sense of data to drive your business forward. #MakeSenseofData #DriveYourBusinessForward #PartnerYourWay

Quality Analyst, Lead Assistant Manager

AnalystAnalystFull TimeRemoteSeniorTeam 10,001+H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

4 days ago

Salary

$60.1K - $98.7K / year

Seniority

Senior

Associate Degree7 yrs expEnglish

Job Description

Quality Analyst, Lead Assistant Manager

EXL

• Oversees work performed by the home health clinical audit program to ensure that EXL’s standard of accuracy is met. • Undertakes quality review of random and targeted clinical coding audits, involving and consulting with clinical auditors, clinicians, and managers to enhance the accuracy and completeness of audits performed. • Develops audit feedback sessions to all staff from routine internal audit, identifying general training trends and requirements.

Job Requirements

  • Registered Nurse with a license in good standing in the state that you reside
  • 7 plus years of home health experience
  • Previous auditing experience
  • OASIS certification and/or coding certification preferred
  • Experience, or equivalent, coding or auditing of Home Health OASIS and non-OASIS claims
  • Ability to review SOC/ROC/Recert assessments to ensure appropriateness, completeness, and compliance with federal and state regulations and organization policy
  • Ability to ensure appropriate ICD-10 coding and sequencing as it relates to the patient’s medical condition
  • Knowledge of CMS/Chapter 7 Home Health Coverage Guidelines, National Coverage Guidelines, and HH PPS Reimbursement
  • Ability to pinpoint, extract, and use record information to cite issues related to the overpayment
  • Assists the program/team in returning client overpayments and achieving internal revenue goals
  • Superior clinical auditing and monitoring skills
  • Excellent decision-making skills and sound judgement
  • Thorough understanding of medical terminology and human physiology
  • Strong technical knowledge and ability to learn new systems quickly
  • Excellent verbal and written communication skills
  • Ability to mentor and instruct through audits
  • Strong organizational skills and high attention to detail
  • Demonstrated flexibility and adaptability
  • Ability to work in a team environment and independently as needed
  • Working knowledge of Microsoft Excel

Benefits

  • For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits

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