Quality Analyst - Clinical Validation Auditor (CVA), Healthcare

This is a remote office opportunity. The Quality Analyst oversees work performed by the Clinical CVA auditors to ensure that EXL’s standard of accuracy is met. The analyst undertakes a quality review of random and targeted clinical CVA audits.
A brief coding/auditing assessment may be included as part of the interview process
Estimated salary range is $60,100 to $98,700 plus bonus
For more information on benefits and what we offer please visit us at  https://www.exlservice.com/us-careers-and-benefits

Responsibilities
- Apply clinical judgment for DRG audits to ensure accuracy of inpatient DRG coding

- Responsible for reviewing the accuracy and consistency of clinical DRG auditing auditors to ensure audits are appropriately marked for findings and no findings

- Mentor Clinical DRG auditors

- Recommend process changes to improve quality and performance

- Communicate with peers and management

- Provide root cause analysis on errors

- Perform other duties as assigned

- Conduct all job functions and responsibilities in accordance with all company Compliance, Information Security and Regulatory policies, procedures and programs

Qualifications
- Current Registered Nurse license

- 5 plus years experience working with clinical validation audits

Knowledge and Skills:

- Superior auditing and monitoring skills

- Ability to mentor and instruct

- Excellent decision making skills and sound judgment

- Thorough understanding of medical terminology and human physiology

- Strong technical knowledge and ability to learn new systems quickly

- Excellent oral/presentation and written communication skills

- Ability to complete tasks efficiently and resolve problems within set timelines

- Strong organizational skills and attention to detail

- Ability to work in a team environment and independently as needed

- Demonstrated flexibility and adaptability

- Must be able to work under deadlines. Must be able to utilize independent decision-making skills in a wide variety of situations

- Requires a high degree of accuracy in the performance of varied responsibilities.

- Personal computer skills required. Must be self-motivated to complete work in a timely manner to meet deadlines

- Strong interpersonal skills required

The posted base salary range is the hiring base salary range for this role. Final offers are based on several factors, including: the candidate's skills and experience, internal pay equity, work location, market conditions for the role, and the specific scope and responsibilities of the position.