EXL

Analyzes business data and runs outsourced operations

Assistant Manager Auditors

Clinical Support & Patient AdministrationConfirmed live in the last 24 hours

Full-timeChennai, Tamil Nadu, IndiaNo salary listedIn-person

About the Job

Requirements

A Bachelor's degree in Science or Nursing is required.
CPC or CPMA certification is required, with at least 3 years of experience after certification.
At least 4 years of experience in medical coding for IVR and general surgery is required.
At least 5 years of experience in inpatient DRG coding or auditing is required.
At least 1–2 years of experience in a Quality Analyst or Quality Auditing role is required.
Strong verbal and written communication skills, including documentation, are required.
Knowledge of HIPAA compliance and data security standards is required.
Proficiency with Microsoft Excel, Outlook, and Word is required.
Problem-solving skills are required.
Ability to follow standard operating procedures, project protocols, workflows, client instructions, and telecommuter policy is required.
A high-speed broadband internet connection at home is required for telecommuting.
Ability to work 40 hours per week on a full-time schedule, 8:00 AM to 5:00 PM IST, with weekends off, is required.

Responsibilities

Perform comprehensive secondary quality audits on inpatient medical records reviewed by DRG Auditors.
Validate principal and secondary diagnoses, procedures, present-on-admission indicators, discharge disposition, and final DRG assignment.
Ensure compliance with IPPS regulations, ICD-10-CM/PCS guidelines, official coding conventions, and payer- and client-specific requirements.
Follow standard operating procedures and project-specific protocols, workflows, and client instructions.
Use quality tools, 3M software, NLP tools, and internal systems for audit and reporting activities.
Complete assigned audits and meet quality, service-level-agreement, and production targets.
Update productivity logs, clarification logs, monitoring trackers, and other applicable logs daily.
Escalate issues and identify error trends.
Check with the Manager or Team Lead when clarification is needed, and respond promptly to emails from the Manager or Leads.
Ensure the team complies with HIPAA and OIG requirements.

Desired Qualifications

Prior experience conducting inpatient DRG quality audits is preferred.
Hands-on exposure to 3M encoder software and NLP tools is preferred.
Strong Microsoft Excel skills for trackers, analysis, and reporting are preferred.
Experience in service-level-agreement-driven, high-compliance healthcare environments is preferred.
Experience working in a Quality team is an added advantage.

ADDITIONAL AND ESSENTIAL RESPONSIBILITIES:

Follow every aspect of SOP without fail.

Complete received Audits for quality review and ensure quality output.

To achieve Quality SLA and quality production target.

Excellent verbal and written communication.

Follow project related protocols and instructions.

Escalate issues, identify error trends.

Update all the required monitoring trackers.

All emails from Leads/Manager should be answered promptly without fail.

Ensure to adhere with HIPAA compliance.

Good excel skills.

Flexibility

Good Communication

Qualifications:

Education - Bachelor’s Degree in Science or Nursing.
CPC/CPMA; Min. 3+ Years experience After Certification

4 years to 12 years’ experience in medical coding IVR and General surgery
Working in Quality team is an added advantage.
Minimum 5 years of experience in Inpatient DRG coding or auditing.
Minimum 1–2 years of experience in a Quality Analyst or Quality Auditing role.
Preferred Qualifications (Desirable Criteria)
Prior experience conducting IP DRG quality audits.
Hands-on exposure to 3M encoder software and NLP tools.
Strong proficiency in Microsoft Excel, including trackers, analysis, and reporting.
Experience working in SLA-driven, high-compliance healthcare environments.

Communication: Strong written (documentation) and oral communication skills

Working Hours:

40 hours per week as Full-time employee
Shift time: 08:00AM TO 05:00PM IST
Weekends Off

Telecommuter/Internet requirements, if applicable:

High Speed internet connection at home, must be broadband
Must understand and adhere with telecommuter policy

Responsibilities and Essential Functions:

Perform comprehensive secondary quality audits on inpatient medical records reviewed by DRG Auditors.
Validate accuracy of principal and secondary diagnoses, procedures, POA indicators, discharge disposition, and final DRG assignment.
Ensure compliance with IPPS regulations, ICD-10-CM/PCS guidelines, official coding conventions, and payer/client-specific requirements.
Adhere strictly to all Standard Operating Procedures (SOPs) without deviation.
Ensure 100% compliance with HIPAA and data security standards at all times.

Use quality tools, 3M software, NLP tools, and internal systems effectively for audit and reporting activities.
Demonstrate strong working knowledge of Microsoft Excel, Outlook, and Word for documentation and reporting.
Follow all project-specific protocols, workflows, and client instructions.
QC check
Follow every aspect of SOP without fail
Complete received Audits with Quality
To achieve Quality and production target
Follow project related protocols and instructions
Escalate issues, identify trends...
Update all the logs like productivity, Clarification log, and any other logs applicable on a daily basis.
Check with Manager /TL in case of clarifications
All emails from Manager should be answered promptly without fail
Problem solving skill sets
Ensure compliance of entire team for HIPAA,OIG

About the Company

EXL

Analyzes business data and runs outsourced operations

EXL analyzes business data and runs outsourced operations for insurers, healthcare payers, banks, retailers, and other large organizations. Its teams combine industry expertise with data engineering and AI to handle tasks such as claims processing, payment reviews, customer service, and finance within existing technology environments. The company also builds software, including LifePRO, which manages insurance policies, and EXLdata.ai, which connects fragmented data for use in AI systems. Clients pay for consulting projects, ongoing managed services, and software delivered through the cloud. EXL was founded in 1999 and is headquartered in New York City.

Company size: 10,001+
Company stage: IPO
Headquarters: New York City, New York
Founded: 1999

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