EXL

Diagnosis-Related Group (DRG) - Auditor III, Healthcare

EXL  â€˘  $70k - $90k/yr  â€˘  United States (Onsite)  â€˘  1 month ago
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Job Description

Why EXL?

At EXL, we believe in fostering an environment where our employees can learn, grow, and succeed We provide industry-leading training, career development opportunities, and a competitive benefits package to ensure you can focus on what you do best—delivering excellence in DRG auditing. If you're looking for a role where you can make a real impact while maintaining work-life balance, this is it!

🔍What You’ll Do:

✔Conduct comprehensive MS-DRG and APR-DRG coding reviews to ensure accuracy in DRG assignment and reimbursement.

✔Apply expert knowledge of coding guidelines and utilize industry-leading tools to maximize overpayment identifications.

✔Craft clear, concise, and well-supported audit findings, backed by AHA Coding Clinic Guidelines and ICD-10-CM/PCS regulations.

✔Utilize advanced DRG encoder tools (such as 3M, Webstrat) to drive efficiency and accuracy in audits.

✔Meet or exceed EXL’s quality and productivity standards, including strong uphold rates for appeals.

✔Stay ahead of industry trends, coding updates, and compliance regulations to maintain expert-level knowledge.

✔Adhere to HIPAA and EXL policies and procedures to ensure data security and regulatory compliance.

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

What We’re Looking For:

🔹 Education & Credentials:

  • Minimum High School Diploma (Higher education preferred).
  • CCS, RHIA, or RHIT credential (Multiple credentials preferred).

🔹 Experience & Expertise:

  • 4+ years of MS-DRG/APR-DRG coding experience with a deep understanding of AHA Coding Guidelines and DRG reimbursement methodologies
  • Prior experience in DRG retrospective overpayment identification auditing is highly desirable.
  • Strong proficiency with DRG encoder tools (3M, Webstrat).

🔹 Key Skills & Attributes:
âś… Expert-level inpatient coding knowledge with an in-depth understanding of ICD-10-CM/PCS coding guidelines
âś…Self-motivated and able to work independently in a remote environment while maintaining high performance.
âś…Exceptional time management, problem-solving, and analytical skills
âś…Strong written and verbal communication with attention to detail.
âś…Proficient in Excel, Word, and OneNote, with strong overall computer literacy.
âś…Passion for DRG auditing and a commitment to teamwork, collaboration, and continuous learning

What We Offer:

✨A fast-paced, innovative environment with a team of industry-leading experts
✨Hands-on experience with top-tier clients in the healthcare industry.
✨ Mentorship and career development programs to help you grow professionally.
✨A strong culture of collaboration, support, and inclusivity
✨ Competitive benefits package, including healthcare, vision, dental, and 401(k) options

Ready to Take Your Career to the Next Level?

If you're looking for a rewarding and challenging opportunity where your expertise will be valued, your growth will be supported, and your contributions will make a difference— apply today and become part of the EXL team!

Salary Range for this role is $70,000 - $90,000

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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