Company Name Withheld
Job type part-time
Full job description
Auditor 1 hba nurse - inpatient program contractor
Virtual req #52
Wednesday, march 3, 2021
Overview exl (nasdaq: exls) is a leading operations management and analytics company that designs and enables agile, customer-centric operating models to help clients improve their revenue growth and profitabilityOur delivery model provides market-leading business outcomes using exl’s proprietary business exlerator framework™, cutting-edge analytics, digital transformation and domain expertiseAt exl, we look deeper to help companies improve global operations, enhance data-driven insights, increase customer satisfaction, and manage risk and complianceExl serves the insurance, healthcare, banking and financial services, utilities, travel, transportation and logistics industriesHeadquartered in new york, new york, exl has more than 32,000 professionals in locations throughout the united states, europe, asia (primarily india and philippines), south america, australia and south africaFor more information, visit www.exlservice.comExl health is seeking an experienced and self-motivated nurse auditor - hba, independent contractor for a remote, home office opportunity.
The nurse auditor conducts hospital bill charge audits by reviewing medical records to verify services were provided and charges are appropriateCharge audits identify overcharges, undercharges and unbundled items per carrier contract and industry standardsThey will also be responsible for independent scheduling requiring flexibility and possible travel to provider locationRequires strong clinical experience and technical skillsThree year’s experience with managed care organization, tpa, government agency preferred.
Review medical records to verify services were provided and charges are accurate - identify overcharges, undercharges and unbundled items.
Identify if a discrepancy exists and document the findings using standard documentation guidelines applicable to the program.
Onsite travel – maintain timely communication with audit coordinator regarding scheduling, completion and submission of auditsAbide by the scio travel policy while making travel arrangements for on sites.
Scheduling on sites – acknowledge work that’s assigned, contact providers and schedule date and time to perform onsite, travel onsite as needed and perform audits.
Report any problems in the audit process to manager for resolution.
Comply with hipaa and other regulations regarding the confidentiality of patient information.
Will perform other duties as assigned
Knowledge and skills:
Acute care experience
Rn with current active license
Minimum of 5 years diverse clinical experience
Previous auditing experience internal or external
Cpc, ccs or cmas desired.
What we offer:
Exl health offers an exciting, fast paced and innovative environment, which brings together a group of sharp and entrepreneurial professionals who are eager to influence business decisionsFrom your very first day, you get an opportunity to work closely with highly experienced, world class healthcare consultants.
You can expect to learn many aspects of businesses that our clients engage inYou will also learn effective teamwork and time-management skills - key aspects for personal and professional growth
We provide guidance/ coaching to every employee through our mentoring program wherein every junior level employee is assigned a senior level professional as advisors.
Sky is the limit for our team membersThe unique experiences gathered at exl health sets the stage for further growth and development in our company and beyond.