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.

What We’re Looking For:

🔹Education & Credentials:

• Minimum High School Diploma (Higher education preferred).
• CCS, RHIA, or RHIT credential (Multiple credentials preferred).

🔹Experience & Expertise:

• 4+ years of MS-DRG/APR-DRG coding experience with a deep understanding of AHA Coding Guidelines and DRG reimbursement methodologies.
• Prior experience in DRG retrospective overpayment identification auditing is highly desirable.
• Strong proficiency with DRG encoder tools (3M, Webstrat).

🔹Key Skills & Attributes:
✅Expert-level inpatient coding knowledge with an in-depth understanding of ICD-10-CM/PCS coding guidelines.
✅Self-motivated and able to work independently in a remote environment while maintaining high performance.
✅Exceptional time management, problem-solving, and analytical skills.
✅Strong written and verbal communication with attention to detail.
✅Proficient in Excel, Word, and OneNote, with strong overall computer literacy.
✅Passion for DRG auditing and a commitment to teamwork, collaboration, and continuous learning.

What We Offer:

✨A fast-paced, innovative environment with a team of industry-leading experts.
✨Hands-on experience with top-tier clients in the healthcare industry.
✨Mentorship and career development programs to help you grow professionally.
✨A strong culture of collaboration, support, and inclusivity.
✨Competitive benefits package, including healthcare, vision, dental, and 401(k) options.

Ready to Take Your Career to the Next Level?

If you're looking for a rewarding and challenging opportunity where your expertise will be valued, your growth will be supported, and your contributions will make a difference—apply today and become part of the EXL team!

Salary Range for this role is $70,000 - $90,000

For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits