EXL

Analyzes business data and runs outsourced operations

Quality Auditor

Clinical Support & Patient AdministrationConfirmed live in the last 24 hours

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

About the Job

Requirements

At least 3 years of experience after obtaining the required certification.
At least 5–7 years of coding experience with quality experience.
At least 1–2 years of experience in a Quality Analyst or Quality Auditing role.
Experience with complex-level IVR coding, cardiovascular surgery coding, and general surgery coding is mandatory.
One or more of the following certifications is mandatory: Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC), or Certified Professional Coder (CPC).
A Bachelor’s Degree in Science or Nursing is required.
Experience working in a high-compliance healthcare environment is required.
Knowledge of project-related protocols and instructions, team clarifications, client emails and queries, issue escalation, trend identification, and compliance requirements is required.
The ability to analyze grey areas and research solutions is required.
Compliance with HIPAA and Office of Inspector General requirements is required.

Responsibilities

Perform detailed quality audits of coded medical records to ensure accuracy, compliance, adherence to official coding guidelines, and adherence to payer-specific requirements.
Review and analyze clinical documentation for completeness and accuracy when assigning Current Procedural Terminology (CPT), International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM), and Healthcare Common Procedure Coding System (HCPCS) codes.
Identify coding errors, trends, and areas for improvement, and provide actionable feedback and recommendations to the coding team.
Collaborate with coding managers and training teams to support process improvement and coding education initiatives.
Stay current with updates to coding standards, payer regulations, and compliance requirements.
Manage inventory and planning activities.
Motivate and guide the team to achieve production and quality goals.
Handle team clarifications and team issues proactively.
Conduct team education and training.
Respond promptly to manager emails.
Ensure compliance across the entire team with HIPAA and Office of Inspector General requirements.

Desired Qualifications

Certified Professional Medical Auditor (CPMA) certification.
Strong proficiency in Microsoft Excel, including trackers, analysis, and reporting.
Experience working in Service Level Agreement-driven, high-compliance healthcare environments.
Experience working in a quality team.
Strong problem-solving, analytical, and innovative capabilities.

3+years of experience after certification is must
Perform detailed quality audits of coded medical records to ensure accuracy, compliance, and adherence to official coding guidelines and payer-specific requirements.
Review and analyze clinical documentation for completeness and accuracy in assigning CPT, ICD-10-CM, and HCPCS codes.
Identify coding errors, trends, and areas for improvement; provide actionable feedback and recommendations to the coding team.
Collaborate with coding managers and training teams to support process improvement and coding education initiatives.
Stay current with updates to coding standards, payer regulations, and compliance requirements.

Education - Bachelor’s Degree in Science or Nursing.

Certifications

One or more of the following mandatory certifications:

3+years of experience after certification is must

CCS – Certified Coding Specialist

CIC – Certified Inpatient Coder

CPC – Certified Professional Coder

Experience -

5 - 7 year of Coding with quality experience
Specialty worked: IVR – Mandatory (Must be dealt with complex level IVR coding, cardiovascular surgery and General surgery
3+years of experience after certification is must
CPMA certification is added advantage.
Location –Chennai
QC experience

Minimum 1–2 years of experience in a Quality Analyst or Quality Auditing role.

Preferred Qualifications (Desirable Criteria)

Strong proficiency in Microsoft Excel, including trackers, analysis, and reporting.

Experience working in SLA-driven, high-compliance healthcare environments.

Must be an expert
Team handling skill set
Working in Quality team is an added advantage.
Inventory management and planning
Motivate and guide team to achieve production and quality goal set
Follow project related protocols and instructions
Handling team clarification
To be proactive in handling team issues
Problem solving skill sets
Research on grey areas with solution
Capable of conducting team education and training
Skill sets to address client email and queries
Should have more analytical skill sets
Should be more innovative, energetic and positive thoughts
Having skill sets to motivate teams
Escalate issues, identify trends
All emails from Manager should be answered promptly without fail
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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