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Clinical Validation Auditor – Trainer

AuditorAuditorFull TimeRemoteTeam 10,001+H1B No SponsorCompany Site LinkedIn

Location

United States

Posted

63 days ago

Salary

$85K - $90K / year

Bachelor Degree5 yrs expEnglish

Job Description

• Deliver engaging and impactful learning experiences to new hire and tenured CVA coders • Apply clinical and DRG expertise to support training and education related to inpatient DRG validation and coding accuracy. • Review clinical DRG audit outcomes to assess consistency and accuracy, using findings to inform training, coaching, and remediation efforts. • Mentor and coach Clinical DRG Auditors through targeted education, feedback, and knowledge reinforcement. • Analyze audit trends and identify learning gaps or referral needs for additional DRG coding education or review. • Perform root cause analysis on audit errors and translate findings into actionable training and performance support. • Utilize industry standards and EXL proprietary tools to support DRG validation training and education. • Develop clear, professional training communications and materials that document audit scenarios, findings, and clinical rationale. • Recommend training and process improvements to enhance audit quality and performance outcomes. • Communicate effectively with peers, auditors, and management regarding training needs, trends, and progress. • Perform all responsibilities in accordance with company compliance, information security, and regulatory requirements. • Perform other duties as assigned.

Job Requirements

Registered Nurse, associate or bachelor's degree
5+ years of acute care nursing experience with preference given to candidates with prior clinical or coding validation audit experience.
2+ years of experience facilitating training delivery
Prefer candidate with prior DRG retrospective overpayment identification auditing experience.
Prefer candidate with prior readmission (PPR) auditing experience.
Preference given to candidates with CCS, RHIA, or RHIT coding credentials.
Demonstrated skill in training facilitation, including delivering instructor-led, virtual, and blended training to adult learners.
Ability to explain complex coding guidelines and audit concepts in a clear, engaging, and practical manner.
Strong communication and facilitation skills, with the ability to engage learners and manage group dynamics in a virtual environment.
Analytical skills to identify knowledge gaps, recurring errors, and training opportunities based on audit trends.
Extensive knowledge and understanding of clinical criteria documentation requirements used to successfully substantiate code assignments.
Ability to work collaboratively with Quality, Audit, and SME partners in a cross-functional, remote environment.
Strong organizational and time-management skills to manage multiple training initiatives and deadline.
Experience with DRG encoder tools (Solventum/3M, TruBridge, Webstrat).
Works independently in a remote environment and delivers exceptional results during EXL core business hours.
Possesses excellent time management and work prioritization skills.
Demonstrates excellent written and verbal communication skills, strong analytical skills, and attention to detail.
Proficient in Excel, Word, and OneNote with general computer literacy.
Comfort using technology-based training and collaboration tools (e.g., virtual meeting platforms, LMS, MS Teams)
Passionate about DRG Auditing with a desire to work in an environment thriving on teamwork, excellence, collaboration.

Benefits

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.
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.
We provide guidance/coaching to every employee through our mentoring program wherein every junior-level employee is assigned a senior-level professional as an advisor.
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.