Job Description

This is a remote office opportunity. The Quality Analyst III oversees work performed by the high cost drug audit program to ensure that EXL’s standard of accuracy is met. The analyst undertakes a quality review of random and targeted coding audits to ensure quality requirements are met. Additionally, the analyst provides mentoring of staff to increase their knowledge in the HCD program. The analyst develops audit feedback sessions for initial auditors, identifying general training trends and requirements.

Salary Range: $50,000 – $65,000 (based on experience, skills, and qualifications)
Location: 100% Remote (U.S.-based)

Up to 10% annual travel (for team meetings and limited client onsite engagements.

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

The posted range is the hiring range for this role — a subset of the broader range available to employees over time — and reflects base salary across our national hiring scale. Final offers are based on several factors, including the candidate's skills and experience, internal pay equity, work location, market conditions for the role, and the specific scope and responsibilities of the position. The top of the range is reserved for candidates who notably exceed the requirements; the lower end applies to those with less experience or fewer preferred qualifications. For positions based in higher-cost zones (e.g., California, New York, New Jersey), actual compensation may exceed the posted range; your recruiter will share specifics during the process.

• Responsible for reviewing the accuracy and consistency of coding auditors to ensure high cost drug audits are appropriately identified as findings or no findings and processed accordingly.
• Assist in mentoring Coders
• Recommend process changes to improve quality and performance
• Communicate with peers and management
• Provide root cause analysis on errors
• Will perform other duties as assigned
• Conduct all job functions and responsibilities in accordance with all company Compliance, Information Security and Regulatory policies, procedures and programs

• Strong HCD coding skills
• Payment Integrity experience relating to overpayment identification for HCD/Infusion products
• Excellent decision-making skills and sound judgment
• Strong technical knowledge and ability to learn new systems quickly
• Excellent oral/presentation and written communication skills
• Ability to complete tasks efficiently and resolve problems within set timelines
• Ability to mentor and instruct
• Strong organizational skills and attention to detail
• Ability to work in a team environment and independently as needed
• Demonstrated flexibility and adaptability
• Must be able to work under deadlines. Must be able to utilize independent decision-making skills in a wide variety of situations
• Requires a high degree of accuracy in the performance of varied responsibilities
• Personal computer skills required. Must be self-motivated to complete work in a timely manner to meet deadlines
• Strong interpersonal skills required

Qualifications / Experience

• Minimum 5 years relevant high cost drug coding experience
• CPC Coding Certification (Preferred)
• Pharmacy Tech Certification (Preferred)

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.