Diagnosis-Related Group (DRG) - Auditor III, Healthcare

Why EXL ?

At EXL , we believe in fostering an environment where our employees can learn, grow, and succeed . We provide industry-leading training, career development opportunities, and a competitive benefits package to ensure you can focus on what you do best—delivering excellence in DRG auditing. If you're looking for a role where you can make a real impact while maintaining work-life balance , this is it!
🔍What You’ll Do:

✔Conduct comprehensive MS-DRG and APR-DRG coding reviews to ensure accuracy in DRG assignment and reimbursement.
✔Apply expert knowledge of coding guidelines and utilize industry-leading tools to maximize overpayment identifications.
✔Craft clear, concise, and well-supported audit findings , backed by AHA Coding Clinic Guidelines and ICD-10-CM/PCS regulations.
✔Utilize advanced DRG encoder tools (such as 3M, Webstrat ) to drive efficiency and accuracy in audits.
✔Meet or exceed EXL ’s quality and productivity standards , including strong uphold rates for appeals.
✔Stay ahead of industry trends, coding updates, and compliance regulations to maintain expert-level knowledge.
✔Adhere to HIPAA and EXL policies and procedures to ensure data security and regulatory compliance.

A brief coding/auditing assessment may be included as part of the interview process

Originally posted on Himalayas