EXL

Clinical Validation Auditor (CVA) Auditor III

EXL  â€˘  $70k/yr  â€˘  United States (Remote)  â€˘  10 hours ago
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Job Description

Are you a nurse with a strong understanding of inpatient care and a passion for getting the details right? Join EXL as a Clinical Validation Auditor and help ensure medical claims are coded accurately and fairly. This is a fully remote position where you’ll use your clinical judgment to review medical records, validate billed DRG codes, and help identify overpayments.

A brief coding/auditing assessment may be included as part of the interview process

🔍 What You’ll Be Doing:

  • Review inpatient medical records to verify that the DRG (Diagnosis-Related Group) code makes sense based on the documentation.
  • Apply clinical and coding knowledge to spot inaccuracies and identify potential overpayments.
  • Document your findings in clear, professional language that explains the rationale behind your review.
  • Use industry tools like 3M or Webstrat (don’t worry—we’ll train you if needed!) to support your decisions.
  • Work independently while meeting productivity and quality goals.
  • Stay up to date with clinical guidelines, DRG rules, and industry trends.

🎓 What We’re Looking For:

  • Registered Nurse (RN) with an active license.
  • 5+ years of acute care experience (hospital setting preferred)
  • Experience in DRG audits or coding validation is a big plus!
  • Bonus points if you have certifications like CCS, RHIA, or RHIT
  • Knowledge of readmission reviews (PPR) is also a plus

✅ You’ll Be a Great Fit If You:

  • Love digging into the details and solving problems
  • Know how to explain clinical decisions clearly and professionally
  • Can manage your time well and stay focused working remotely
  • Are comfortable using tools like Excel, Word, and OneNote
  • Enjoy working as part of a supportive, high-performing team

đź’Ľ Why Work at EXL?

At EXL, you’ll join a team that values collaboration, clinical accuracy, and continuous improvement. We offer the flexibility of remote work, a culture of support, and the opportunity to grow in the fast-evolving world of healthcare analytics.

Ready to take the next step in your clinical career? Apply today and make a difference with EXL!

Salary range for this role is $70k - $80k

For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits


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 54,000 employees spanning six continents. For more information, visit www.exlservice.com EXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates. EXL will only extend a job offer after a candidate has gone through a formal interview process with members of EXL’s Human Resources team, as well as our hiring managers.

EXL

About EXL

Choosing a digital partner is about more than capabilities — it’s about collaboration and character.

Unrealistic overhauls and off-the-shelf products ignore what matters most — your unique needs, culture, goals, and your legacy data and technology environments.

At EXL, our collaboration is built on ongoing listening and learning to adapt our methodologies. We’re your business evolution partner—tailoring solutions that make the most of data to make better business decisions and drive more intelligence into your increasingly digital operations.

Whether your goals are scaling the use of AI and digital, redesign operating models, or driving better and faster decisions, we’re here to partner with you to help you gain—and maintain—competitive advantage with efficient, sustainable models at scale.

Our expertise in transformation, data science, and change management helps make your business more efficient and effective, improve customer relationships and enhance revenue growth. Instead of focusing on multi-year, resource- and time-intensive platform designs or migrations, we look deeper at your entire value chain to integrate strategies with impact.

We use our specialization in analytics, digital interventions, and operations management—alongside deep industry expertise — to deliver solutions that help you outperform the competition.

At EXL, it’s all about outcomes—your outcomes—and delivering success on your terms. Share your goals with us and together, we’ll optimize how you leverage data to drive your business forward.

For more information, visit www.exlservice.com.

Industry
Consulting & Advisory
Company Size
10,000+ employees
Headquarters
New York, NY
Year Founded
Unknown
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