Outpatient Facility Coding Subject Matter Expert (SME)

EXL
New York, NY
Category Data Analyst
Job Description
The Facility Coding SME is responsible for the selection and audit of professional claims, ensuring correct coding, reimbursement, and compliance with established guidelines. They collaborate with the selection analytics team and the clinical specialist, providing insights into client data and payment methodologies. The role involves leading a team and contributing to program growth.

Requirements

  • Lead a team of coding auditors.
  • Review selected professional claims.
  • Collaborate with the audit staff.
  • Evaluate client data.
  • Ensure correct coding guidelines are followed.
]]>