Certified Outpatient Coder - Remote Work from Home

Company Overview and Culture
EXL (NASDAQ: EXLS) is a leading data analytics and digital operations and solutions company. We partner with clients using a data and AI-led approach to reinvent business models, drive better business outcomes and unlock growth with speed. EXL harnesses the power of data, analytics, AI, and deep industry knowledge to transform operations for the world's leading corporations in industries including insurance, healthcare, banking and financial services, media and retail, among others. EXL was founded in 1999 with the core values of innovation, collaboration, excellence, integrity and respect. We are headquartered in New York and have more than 55,000 employees spanning six continents. For more information, visit http://www.exlservice.com.

As a Remote Certified Outpatient Coder you will apply your expert knowledge of outpatient coding and reimbursement and CPT coding guidelines in the auditing of outpatient and professional fee medical records to validate or revise the provider's billed CPT codes.
You will utilize industry and EXL proprietary tools in the CPT assignment process and will write professional communications documenting audit findings and supporting rationales.
Your expertise will be the driving force behind ensuring fair reimbursement and maintaining the highest standards of healthcare coding integrity.
This is a remote work from home position with occasional travel.

Key Responsibilities:

• Conduct CPT and Ambulatory Payment Classification coding reviews to verify the accuracy of the CPT coding assignment and APC reimbursement on outpatient and professional claims.
• Apply Medicare, NCCI and other coding guidelines to a variety of claim scenarios and effectively utilize industry and proprietary tools to maximize overpayment identifications.
• Document audit results in a clear, concise, and effective manner using AHA Coding Clinic Guidelines and CPT coding rules and guidelines.
• Utilize proprietary workflow systems and encoder tools (3M, Webstrat, Optum Encoder) efficiently and accurately to make audit determinations, generate audit rationales and move claims through workflow process correctly.
• Meet or exceed EXL established program productivity and quality goals, including uphold rate for appeals.
• Demonstrate knowledge of and compliance with changes and updates to coding guidelines, reimbursement trends, and client processes and requirements.
• Comply with all EXL policies and procedures including HIPAA and other state and federal regulations.

Qualifications

Required:

• Required one or more of the following credentials: Certified Coding Specialist CCS, Registered Health Information Administrator RHIA, Registered Health Information Technician RHIT, Certified Professional Coder CPC; preference given to those with multiple credentials.
• 3 years of professional and hospital outpatient coding with expert knowledge of American Hospital Association (AHA) and CPT Coding Guidelines, and APC reimbursement methodologies.
• Familiarity with healthcare payer contract language.

Preferred:

• Prior APC retrospective overpayment identification auditing experience, supporting surgical, radiology, etc.
• Superior knowledge of CPT coding, Official Guidelines for Coding and Reporting and Coding Clinic Guidance, National Correct Coding Initiative guidelines coupled with APC payment methodologies including Medicare Outpatient Prospective Payment System (OPPS)
• Experience with encoder tools such as 3M, Webstrat, Optum Encoder.
• Works independently in a remote environment and delivers exceptional results during EXL core business hours.
• Possesses excellent time management and work prioritization skills.
• Takes ownership of problem solving.
• Excellent written and verbal communication skills, strong analytical skills, and attention to detail.
• Proficient in Excel, Word, and OneNote with general computer literacy.
• Passionate about Outpatient Auditing with a desire to work in an environment thriving on teamwork, excellence, collaboration, inclusiveness, and support.

What We Offer

• EXL Health offers an exciting, fast paced, and innovative environment, which brings together a group of sharp and entrepreneurial professionals who are eager to influence business decisions.
• From your very first day, you get an opportunity to work closely with highly experienced, world class Healthcare consultants.
• You can expect to learn many aspects of businesses that our clients engage in. You will also learn effective teamwork and time-management skills - key aspects for personal and professional growth.
• We provide guidance/ coaching to every employee through our mentoring program wherein every junior level employee is assigned a senior level professional as advisors.
• Sky is the limit for our team members. The unique experiences gathered at EXL Health sets the stage for further growth and development in our company and beyond.

EEO/Minorities/Females/Vets/Disabilities

To view our total rewards offered click here — > https://www.exlservice.com/us-careers-and-benefits

Base Salary Range Disclaimer: The base salary range represents the low and high end of the EXL base salary range for this position. Actual salaries will vary depending on factors including but not limited to: location and experience. The base salary range listed is just one component of EXL's total compensation package for employees. Other rewards may include bonuses, as well as a Paid Time Off policy, and many region specific benefits.

Please also note that the data shared through the job application will be stored and processed by EXL in accordance with the EXL Privacy Policy.

Application & Interview Impersonation Warning – Purposely impersonating another individual when applying and / or participating in an interview in order to obtain employment with EXL Service Holdings, Inc. (the “Company”) for yourself or for the other individual is a crime. We have implemented measures to deter and to uncover such unlawful conduct. If the Company identifies such fraudulent conduct, it will result in, as applicable, the application being rejected, an offer (if made) being rescinded, or termination of employment as well as possible legal action against the impersonator(s).

EXL may use artificial intelligence to create insights on how your candidate information matches the requirements of the job for which you applied. While AI may be used in the recruiting process, all final decisions in the recruiting and hiring process will be taken by the recruiting and hiring teams after considering a candidate’s full profile. As a candidate, you can choose to opt out of this artificial intelligence screening process. Your decision to opt out will not negatively impact your opportunity for employment with EXL.