EXL Services Looking for HBA Nurse Auditor at Remote Full Time

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 profitability. Our delivery model provides market-leading business outcomes using EXL’s proprietary Business EXLerator Framework™, cutting-edge analytics, digital transformation and domain expertise. At EXL, we look deeper to help companies improve global operations, enhance data-driven insights, increase customer satisfaction, and manage risk and compliance. EXL serves the insurance, healthcare, banking and financial services, utilities, travel, transportation and logistics industries. Headquartered 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 Africa. For more information, visit www.exlservice.com.

EXL USA Healthcare is seeking an experienced and self-motivated Nurse Auditor for a full time position – HBA, (Hospital Bill Audit) for a remote, Home Office opportunity with up to 50% travel.

The Nurse Auditor conducts hospital bill audits by reviewing medical records to verify services were provided and charges are appropriate. Charge audits identify overcharges, undercharges and unbundled items per carrier contract, industry standards and Payer Reimbursement policies. They will also be responsible for independent scheduling requiring flexibility and possible travel to provider location. The position requires strong clinical experience and technical skills.

Responsibilities:

• Review medical records to verify services were provided as billed. 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 audits. Abide by the EXL Travel policy while making travel arrangements for onsite audits.
• Scheduling Audits: Manage inventory and schedule audits timely by contacting the provider to schedule date and time to 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.
• Conduct all job functions and responsibilities in accordance with all company Compliance, Information Security and Regulatory policies, procedures and programs.

Qualifications:

• Previous hospital bill auditing experience, internal or external
• Minimum of 5+ years of acute care clinical experience with experience in Medical/Surgery, OR or ICU units
• A current, unrestricted nursing license (RN)
• Ability to travel up to 50% of the time
• CPC, CCS or CMAS desired
• Excel experience is a bonus
• Excellent interpersonal and communication skills
• Demonstrate ability to prioritize tasks

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 decisions. From 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 in. You will also learn effective teamwork and time-management skills – key aspects for personal and professional growth
• The sky is the limit for our team members. The unique experiences gathered at EXL Health sets the stage for further growth and development in our company and beyond.
• Competitive benefit package including medical, dental, vision and 401(k) plans

EEO/Minorities/Females/Vets/Disabilities

Please be aware that EXL requires all employees to be vaccinated for COVID-19. This position will require the successful candidate to obtain and show proof of a vaccination. EXL is an equal opportunity employer, and will provide reasonable accommodation to those individuals who are unable to be vaccinated consistent with federal, state, and local law.

Please also note that the data shared through the job application will be stored and processed by EXL in accordance with the EXL Privacy Policy.