Job description

Company Overview and Culture
EXL (NASDAQ: EXLS) is a global analytics and digital solutions company that partners with clients to improve business outcomes and unlock growth. Bringing together deep domain expertise with robust data, powerful analytics, cloud, and AI, we create agile, scalable solutions and execute complex operations for the world’s leading corporations in industries including insurance, healthcare, banking and financial services, media, and retail, among others. Focused on creating value from data for driving faster decision-making and transforming operating models, EXL was founded on the core values of innovation, collaboration, excellence, integrity and respect. Headquartered in New York, our team is over 40,000 strong, with more than 50 offices spanning six continents. For information, visit www.exlservice.com.

For the past 20 years, EXL has worked as a strategic partner and won awards in its approach to helping its clients solve business challenges such as digital transformation, improving customer experience, streamlining business operations, taking products to market faster, improving corporate finance, building models to become compliant more quickly with new regulations, turning volumes of data into business opportunities, creating new channels for growth and better adapting to change. The business operates within four business units: Insurance, Health, Analytics, and Emerging businesses.

EXL Health is hiring a Clinical Audit - Audit Coordinator I. This is a work from home opportunity!

The Audit Coordinator I is responsible for handling calls/correspondence from providers regarding medical record issues, including submission of medical records, audit status, audit disputes, and general clinical guidance and support needed to complete the audit process. In addition, the Clinical Audit support team is responsible for repricing audits with partial findings, sending external appeals to Client, medical record invoicing set up, assisting with locating medical records, and providing monthly reports to the Client.

Responsibilities:

• Answer Provider phone calls, request missing documentation, log and return voicemail.
• Monitor and respond to email correspondence, both internal and external.
• Setup and prepare invoices for payment.
• Serve as a liaison for internal and external clients, including screening phone calls, facilitating client communications to the appropriate client leader and following up with clients, when appropriate.
• Become familiar with client reports and internal reports and assist in their preparation.
• Interact with internal staff and client to re-price audits with validation/audit findings.
• Ensure all audit issues are documented in the applicable audit program Audit System.
• Escalate issues to management and handle for Follow Up action as needed.
• Review and process files received in the appeal exception folder.
• Provide back-up scanning assistance to correspondence emailing as needed.
• Provide back-up assistance to other Audit Coordinators as needed.
• Comply with HIPAA and other regulations regarding confidentiality of information.
• Other duties as assigned to support the audit process and/or company-wide programs.

Required:

• High School Diploma - Associate degree or relevant certification is a plus
• Previous customer service or call center experience
• Solid knowledge of Microsoft Office necessary, especially Excel, Word, and Outlook
• 1 years’ minimum experience working as a Claims Analyst or Claims Auditor in a managed care setting (hospital, health plan or physician office)
• Highly organized, detail oriented and solid problem-solving skills
• Able to make recommendations to improve and streamline processes to make more efficient
• Ability to positively and comfortably handle and prioritize multiple tasks in a fast-paced environment with focused attention to detail
• High level of integrity and confidentiality
• Possesses time management skills; exhibits solid ability to prioritize work and perform multi-tasks.
• Basic knowledge of medical claims
• Prior coding or medical claims experience or training
• Strong written and verbal communication skills

EEO/Minorities/Females/Vets/Disabilities

Please be aware that EXL requires all employees to be vaccinated for COVID-19. This position will require the successful candidate to obtain and show proof of a vaccination. EXL is an equal opportunity employer, and will provide reasonable accommodation to those individuals who are unable to be vaccinated consistent with federal, state, and local law.

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.

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