EXL
EXL
EXL is a business consulting and services company that helps organizations use data, analytics, and technology to improve operations and make better decisions. Its work includes operations management, decision analytics, and digital transformation, with experience supporting clients in healthcare, insurance, finance, and logistics. EXL combines data science with practical business expertise to develop solutions tailored to each organization’s goals, operating model, and industry context.

Senior Healthcare Coding Quality Auditor

Audit complex medical coding, including IVR cases, for accuracy and compliance. Guide team performance, resolve coding issues, and support HIPAA and OIG adherence in Chennai.

Description

  • Audit coded medical records for accuracy, compliance, coding guidelines, and payer requirements.
  • Review clinical documentation and verify CPT, ICD-10-CM, and HCPCS code assignments.
  • Spot coding errors and trends, then give the coding team feedback and recommendations.
  • Work with coding managers and trainers to improve processes and deliver coding education.
  • Keep current with coding standards, payer rules, and compliance requirements.
  • Guide the team toward production and quality targets.
  • Oversee inventory and planning.
  • Resolve team questions and issues by researching unclear cases and recommending solutions.
  • Deliver team education and training.
  • Respond to client emails and queries.
  • Escalate issues and flag recurring trends.
  • Respond promptly to managers’ emails.
  • Ensure the team follows HIPAA and OIG requirements.

Requirements

  • Bachelor’s degree in science or nursing.
  • At least one required certification: CCS (Certified Coding Specialist), CIC (Certified Inpatient Coder), or CPC (Certified Professional Coder).
  • At least three years of experience after certification.
  • Four to six years of coding experience, including quality work.
  • Experience with IVR coding, including complex cardiovascular and general surgery cases.
  • At least one to two years in a Quality Analyst or quality auditing role.
  • Quality control experience.
  • Strong Microsoft Excel skills, including trackers, analysis, and reporting.
  • Experience in SLA-driven, high-compliance healthcare settings.
  • CPMA certification is an advantage.
  • Based in Chennai.

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