Outpatient Auditor III

EXL
New York, NY
Category Accounting
Remote
Job Description
EXL is seeking a Remote Certified Outpatient Auditor III to validate or revise CPT codes and claims. This role involves auditing outpatient and professional fees, applying coding guidelines, and ensuring accurate billing. The position offers remote work and occasional travel, and emphasizes accuracy, compliance, and utilizing proprietary workflows.

Requirements

  • Conduct CPT and Ambulatory Payment Classification (APC) reviews.
  • Apply Medicare, NCCI, and other coding guidelines.
  • Document audit findings and rationales professionally.
  • Meet or exceed EXL's productivity and quality goals.
  • Stay up-to-date on coding guideline changes and reimbursement trends.
  • Maintain compliance with EXL’s policies and procedures.
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