Quality Analyst - Clinical Validation Auditor (CVA), Healthcare

About

The Quality Analyst oversees work performed by the Clinical CVA auditors to ensure that EXL’s standard of accuracy is met, undertaking quality reviews of random and targeted clinical CVA audits.

Requirements

• Current Registered Nurse license
• 5 plus years experience working with clinical validation audits
• Superior auditing and monitoring skills
• Thorough understanding of medical terminology and human physiology
• Excellent oral/presentation and written communication skills

Responsibilities

• Apply clinical judgment for DRG audits to ensure accuracy of inpatient DRG coding
• Review the accuracy and consistency of clinical DRG auditing auditors
• Mentor Clinical DRG auditors
• Recommend process changes to improve quality and performance
• Provide root cause analysis on errors

Benefits

• Competitive salary
• Benefits package available