Skilled Nursing Facility (SNF) / Resource Utilization Group (RUG) Auditor III, Healthcare

EXL Talent Acquisition Team

109d

About The Position

In this fully remote position as a Skilled Nursing Facility auditor you will apply your expert clinical knowledge to validate the accuracy of billed charges to ensure the integrity of the paid claim including coding validation, payment accuracy, contractual requirements and compliance with regulations. You will utilize industry and EXL proprietary tools in the review process, and will write professional communications documenting audit findings and supporting rationales. You will also apply your extensive clinical and industry knowledge to identify audit trends and opportunities.

Responsibilities

• Validate the accuracy of billed charges to ensure the integrity of the paid claim.
• Conduct coding validation and payment accuracy checks.
• Ensure compliance with contractual requirements and regulations.
• Utilize industry and EXL proprietary tools in the review process.
• Document audit findings and support rationales through professional communications.
• Identify audit trends and opportunities using clinical and industry knowledge.

What This Job Offers

• Number of Employees: 5,001-10,000 employees