Job Description

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

Salary for this role is $85k - $95k

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

Responsibilities:

• Deliver structured training and facilitation for SNF/PDPM auditors, including new hire onboarding and ongoing development
• Translate audit findings and error trends into targeted training, coaching, and reinforcement activities
• Provide one-on-one and group coaching to address performance gaps and improve audit accuracy and consistency
• Support trainees in developing strong clinical documentation interpretation and classification logic for SNF claims
• Reinforce application of PDPM components, including MDS-driven reimbursement factors
• Conduct observation sessions, case reviews, and teach-back activities to validate learner understanding and application
• Utilize progress reports and performance data to identify trends, root causes, and opportunities for intervention
• Support trainees in achieving performance expectations and progressing efficiently through training to independent production
• Partner with Quality, Audit, and SMEs to ensure alignment on audit logic, regulatory guidance, and training priorities
• Maintain accurate training documentation, including progress tracking, coaching notes, and performance updates
• Own and contribute to the development and enhancement of training materials, case studies, and job aids

Knowledge and Skills:

• Strong working knowledge of MDS, PDPM components, and MDS-driven reimbursement
• Ability to interpret clinical documentation and apply classification logic accurately in an audit setting
• Demonstrated ability to facilitate instructor-led, virtual, and blended training for adult learners
• Ability to translate complex regulatory and clinical concepts into clear, practical, and engaging learning experiences
• Strong analytical skills to identify error patterns, knowledge gaps, and training opportunities based on audit data
• Effective communication and facilitation skills, with the ability to engage learners and manage group dynamics
• Ability to collaborate cross-functionally with Quality, Audit, and SME partners
• Strong organizational and time management skills to manage multiple priorities and deadlines
• Proficiency with Excel, PowerPoint, Word, Outlook, and Encoder tools (Optum, TrueCode, 3M, Webstrat) and training / collaboration tools (e.g., LMS, MS Teams, Excel, PowerPoint)

Qualifications:

• RN required; Bachelor’s or Master’s degree preferred
• Deep understanding of HIPPS billing codes, MDS 3.0 coding rules, and case management
• Minimum 5 years of experience in a Skilled Nursing Facility and/or Long Term Care, auditing, or payment integrity
• Strong experience with PDPM (Patient-Driven Payment Model)
• Experience with MDS assessments, SNF documentation, and reimbursement structures
• Minimum 3 years of experience delivering training, facilitation, or coaching within a coding or audit environment

Knowledge and Skills:

• Strong working knowledge of MDS, PDPM components, and MDS-driven reimbursement
• Ability to interpret clinical documentation and apply classification logic accurately in an audit setting
• Demonstrated ability to facilitate instructor-led, virtual, and blended training for adult learners
• Ability to translate complex regulatory and clinical concepts into clear, practical, and engaging learning experiences
• Strong analytical skills to identify error patterns, knowledge gaps, and training opportunities based on audit data
• Effective communication and facilitation skills, with the ability to engage learners and manage group dynamics
• Ability to collaborate cross-functionally with Quality, Audit, and SME partners
• Strong organizational and time management skills to manage multiple priorities and deadlines

• Proficiency with Excel, PowerPoint, Word, Outlook, and Encoder tools (Optum, TrueCode, 3M, Webstrat) and training / collaboration tools (e.g., LMS, MS Teams, Excel, PowerPoint)

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 an advisor
• The 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

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.