Outpatient Auditor II

Job description

Are you a skilled Outpatient Auditor with deep expertise in infusion services, complex surgeries, interventional radiology, and hospital-based outpatient care? Do you bring a strong commitment to coding accuracy, regulatory compliance, and appropriate reimbursement? If so, EXL Health is excited to welcome you to our remote auditing team! As a Remote Certified Outpatient Auditor , you’ll apply your in‑depth knowledge of CPT coding, outpatient regulatory guidelines, and APC reimbursement to review outpatient claims across a variety of clinical specialties. Your work will support providers, payers, and patients by validating billed CPT codes, identifying discrepancies, and ensuring adherence to industry standards. This role is fully remote , with up to 10% annual travel for team meetings and occasional client onsite engagements. - Audit outpatient claims with a focus on APC groupings, revenue codes, CPT bundling rules, and UB‑04 facility coding requirements. - Ensure accurate documentation and coding of technical components such as nursing services, equipment use, and place of service. - Verify that facility charges and resource utilization are coded correctly and independently from p...