Job details
Job type full-time
Full job description
Overview
Exl (nasdaq: exls) is a leading operations management and analytics company that designs and enables agile, customer-centric operating models to help clients improve their revenue growth and profitabilityOur delivery model provides market-leading business outcomes using exl’s proprietary business exlerator framework™, cutting-edge analytics, digital transformation and domain expertiseAt exl, we look deeper to help companies improve global operations, enhance data-driven insights, increase customer satisfaction, and manage risk and complianceExl serves the insurance, healthcare, banking and financial services, utilities, travel, transportation and logistics industriesHeadquartered in new york, new york, exl has more than 32,000 professionals in locations throughout the united states, europe, asia (primarily india and philippines), south america, australia and south africaFor more information, visit www.exlservice.com.
Exl health, is seeking an experienced outpatient quality analyst iv - qc coder.
This is a remote office opportunityThe quality analyst iv oversees work performed by the outpatient audit program to ensure that exl’s standard of accuracy is metAudits are performed by validating the accuracy of the coding billed in relation to the medical documentationThe coding auditor determines if a discrepancy exists in the coding and documents the findingsThe analyst undertakes a quality review of random and targeted coding audits to check the accuracy and completeness of audits performedAdditionally, the analyst develops audit feedback sessions to all staff from routine internal audit, identifies training needs and performs training.
Responsibilities:
Responsible for reviewing the accuracy and consistency of coding auditors to ensure audits are appropriately marked for findings and no findings.
Mentor and train outpatient coders
Create and provide updates to training and user manuals
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:
High school diploma
Ccs or cpc certified
Minimum 5 years coding experience: professional or hospital coding
Must have thorough understanding of icd-10 coding; hcpcs/cpt coding systems; medicare outpatient prospective payment system (opps), and ambulatory payment classification (apc)
Experience with and expertise with medicare local coverage determinations (lcd) and national coverage determinations (ncd)
Knowledge and skills:
Must have the ability to code a wide variety of complex outpatient services such as interventional radiology, ambulatory surgery, emergency room and observationReviews medical records to determine if facility coding is accurate.
Proficient in modifier application following appropriate medicare and ncci guidelines
Ability to write professional notes based quoting resources of official coding guidelines, icd-10 coding handbook, coding clinic and/or other recognized sources.
Excellent verbal and written communication skills.
Ability to mentor and instruct through audits.
Strong organizational skills and attention to detail.
Ability to work in a team environment and independently as needed.
Demonstrated flexibility and adaptability.
Superior clinical auditing and monitoring skills.
Excellent decision making skills and sound judgment.
Strong technical knowledge and ability to learn new systems quickly.
Ability to complete tasks efficiently and resolve problems within set timelines.
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 requiredExperience with: excel, powerpoint, outlook, and word
Strong interpersonal skills required.
What we offer:
Exl health offers an exciting, fast paced and innovative environment, which brings together a group of sharp and entrepreneurial professionals who are eager to influence business decisionsFrom your very first day, you get an opportunity to work closely with highly experienced, world class healthcare consultants.
You can expect to learn many aspects of businesses that our clients engage inYou will also learn effective teamwork and time-management skills - key aspects for personal and professional growth
We provide guidance/ coaching to every employee through our mentoring program wherein every junior level employee is assigned a senior level professional as advisors.
Sky is the limit for our team membersThe unique experiences gathered at exl health sets the stage for further growth and development in our company and beyond.
Eeo/minorities/females/vets/disabilities
Please be aware that exl requires all employees to be vaccinated for covid-19This position will require the successful candidate to obtain and show proof of a vaccinationExl is an equal opportunity employer, and will provide reasonable accommodation to those individuals who are unable to be vaccinated consistent with federal, state, and local law.
