Clinical Validation Auditor (CVA) Auditor III

EXL•United States,

7d•$60,100 - $98,700•Remote

About The Position

EXL is hiring a Clinical Validation Auditor to review inpatient medical records, validate billed Diagnosis-Related Group (DRG) codes, and help identify potential overpayments. The role uses clinical judgment and coding knowledge to assess whether DRG codes are supported by documentation and to explain review findings clearly and professionally. Auditors work independently toward productivity and quality goals while staying current with clinical guidelines, DRG rules, and industry trends. This is a 100% remote position for U.S.-based candidates, with up to 10% annual travel for team meetings and limited client onsite engagements. A brief coding or auditing assessment may be included in the interview process. The posted base salary range is $60,100–$98,700, with final offers based on factors including skills, experience, work location, market conditions, and role scope.

Requirements

Registered Nurse (RN) with an active license.
At least 5 years of acute care experience; hospital experience is preferred.
Ability to explain clinical decisions clearly and professionally.
Ability to manage time and stay focused while working remotely.
Comfort using Excel, Word, and OneNote.

Nice To Haves

Experience in DRG audits or coding validation.
Certifications such as CCS, RHIA, or RHIT.
Knowledge of readmission reviews (PPR).
Enjoyment of detail-oriented problem solving and teamwork.

Responsibilities

Review inpatient medical records to verify that DRG codes are supported by the documentation.
Apply clinical and coding knowledge to identify inaccuracies and potential overpayments.
Document findings in clear, professional language and explain the rationale for each review.
Use industry tools such as 3M or Webstrat to support review decisions; training is available if needed.
Work independently while meeting productivity and quality goals.
Stay up to date with clinical guidelines, DRG rules, and industry trends.