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