Quality Analyst Outpatient

Job description

This is a remote office opportunity. The Quality Analyst IV oversees work performed by the Outpatient audit program to ensure that EXL’s standard of accuracy is met. Audits are performed by validating the accuracy of the coding billed in relation to the medical documentation. The coding auditor determines if a discrepancy exists in the coding and documents the findings. The quality analyst undertakes a quality review of random and targeted coding audits to check the accuracy and completeness of audits performed. A brief coding/auditing assessment may be included as part of the interview process - Responsible for reviewing the accuracy and consistency of coding auditors to ensure audits are appropriately marked for findings and no findings. - Provide root cause analysis on errors - Mentor outpatient coders and provide feedback when required - Perform quality reviews for initial audits and appeals - Identify potential opportunities outside of the concept for additional recoveries. - Recommend process changes to improve quality and performance - Communicate with peers and management - Perform other duties as assigned - Conduct all job functions and responsibilities in accordance with...