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EXL

Senior Executive - Coding Auditor

Posted an hour ago
5-10 years experience
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AI Summary

Perform accurate medical coding for complex IVR, cardiovascular, and general surgery cases while meeting production and quality benchmarks. Maintain operational logs, identify coding trends, and ensure strict adherence to HIPAA, OIG, and organizational compliance standards.

  • Perform accurate coding for complex IVR, cardiovascular procedures, and general surgery cases.
  • Apply coding expertise with 2–10 years of relevant experience post CPC certification.
  • Complete assigned audits with high quality and within defined timelines.
  • Adhere strictly to all SOPs, project protocols, and coding guidelines.
  • Meet daily/weekly production and quality benchmarks.
  • Maintain all required logs including productivity, clarification, and other operational trackers.
  • Identify patterns/trends in coding issues and escalate appropriately to TL/Manager.
  • Communicate promptly and professionally through email and meetings.
  • Demonstrate strong problem-solving skills and reliability in a remote work environment.
  • Ensure adherence to HIPAA, OIG, and organizational compliance standards for self and team.

Responsibilities

Responsibilities and Essential Functions:

  1. Follow every aspect of SOP without fail 
  2. Complete received Audits with Quality
  3. To achieve Quality and production target
  4. Follow project related protocols and instructions 
  5. Escalate issues, identify trends...
  6. Update all the logs like productivity, Clarification log, and any other logs applicable on a daily basis.
  7. Check with Manager /TL in case of clarifications 
  8. All emails from Manager should be answered promptly without fail
  9. Problem solving skill sets

Ensure compliance of entire team for HIPAA,OIG

Qualifications

Overview : CVIR

  • CPC certification. 
  • Post CPC certification completion date, there should be 2+ years of coding experience
  • Specialty worked: IVR – Mandatory (Must be dealt with complex level IVR coding, cardio vascular surgery and General surgery)
  • Good communication, flexibility reliability

 Qualifications:

 Life science/Paramedical Degree

  • CPC/CPMA
  • Computer skill sets

 Experience:

  1. 2 years to 10 years’ experience in Medical coding IVR and General surgery
  2. Auditing and denial management experience (Optional)

 Communication: 

  1. Strong written (documentation) and oral communication skills

 Working Hours:

  1. 40 hours per week as Full time employee
  2. Shift time: 08:00AM TO 05:00PM IST
  3. Weekends Off

 Telecommuter/Internet requirements, if applicable:

  1. High Speed internet connection at home, must be broadband
  2. Must understand and adhere with telecommuter policy

EXL (NASDAQ: EXLS) is a leading data analytics and digital operations and solutions company. We partner with clients using a data and AI-led approach to reinvent business models, drive better business outcomes and unlock growth with speed. EXL harnesses the power of data, analytics, AI, and deep industry knowledge to transform operations for the world’s leading corporations in industries including insurance, healthcare, banking and financial services, media and retail, among others. EXL was founded in 1999 with the core values of innovation, collaboration, excellence, integrity and respect. We are headquartered in New York and have more than 54,000 employees spanning six continents. For more information, visit www.exlservice.com.


EXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates. EXL will only extend a job offer after a candidate has gone through a formal interview process with members of EXL’s Human Resources team, as well as our hiring managers.

EXL is the indispensable partner for leading businesses in data-led industries such as insurance, banking and financial services, healthcare, retail and logistics. We bring a unique combination of data, advanced analytics, digital technology and industry expertise to help our clients turn data into insights, streamline operations, improve customer experience, and transform their business. Our partnerships with clients are built on a foundation of collaboration – and we’ve been chosen as a partner by nine of the top ten leading US insurance companies, nine of the top 20 global banks, and six of the top ten US health care payers. We function as one team to make your goals our goals, whether that’s unlocking the value of generative AI or embedding analytics into workflows that reduce risk or power your growth. Clients choose EXL as their transformation partner for many reasons. Our geographic diversity make talent all over the world instantly accessible. Digital accelerators enable unmatched speed-to-value, letting you realize results fast. It’s our people that truly set us apart, though, including the 1,500 data scientists we have dedicated to our generative AI practice. And our more than twenty years of experience in delivering business services, garnering stellar client references, and maintaining a solid balance sheet are reassuring to our C-suite clients. Find out for yourself why clients, employees, and analysts think we’re some of the best in the business. Contact us to see how we can help you achieve your goals.

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