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EXL

EXL is a global company providing business process solutions engineered to help companies streamline operations, simplify compliance, prepare for change, and cr

Quality Analyst – Skilled Nursing Facility, Patient-Driven Payment Model

Location

United States

Posted

3 days ago

Salary

$60.1K - $98.7K / year

Seniority

Senior

Associate Degree5 yrs expEnglish

Job Description

Quality Analyst – Skilled Nursing Facility, Patient-Driven Payment Model

EXL

• Conduct quality reviews of completed audits • Ensure compliance with CMS regulations, internal policies client requirements, and audit methodologies • Evaluate the accuracy, consistency, and defensibility of audit determinations • Identify trends and process improvement opportunities • Contribute to overall quality performance and operational excellence

Job Requirements

  • Registered Nurse, Licensed Practical Nurse, or Licensed Vocational Nurse license in good standing in the state that you reside
  • 5 plus years’ experience with SNF clinical, MDS 3.0 completion, PDPM reimbursement methodology, quality assurance, auditing, and/or related experience
  • Advanced knowledge of MDS 3.0 coding guidelines, skilled nursing facility (SNF) levels of care, and PDPM reimbursement
  • Previous experience/exposure to the billing of HIPPS codes
  • Experience reviewing audit findings, conducting quality revises, or performing compliance monitoring activities
  • Experience with: Excel, PowerPoint, Outlook, and Word
  • Experience with Encoder tools such as 3M
  • Experience with and expertise with Medicare Local Coverage Determinations (LCD) and National Coverage Determinations (NCD)
  • Must be detail oriented
  • Must have excellent verbal and written communication skills
  • Must be self-directed and able to work with minimum oversight

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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