EXL

Quality Analyst - Clinical Validation Auditor (CVA), Healthcare

CVA full-time Mid $60,100 - $98,700
full-time Mid level Technology & IT Salary listed Curated
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About the role

Headquarters: United States
URL: https://fa-ewjt-saasfaprod1.fa.ocs.oraclecloud.com:443/hcmUI/CandidateExperience/

This is a remote office opportunity. The Quality Analyst oversees work performed by the Clinical CVA auditors to ensure that EXL’s standard of accuracy is met. The analyst undertakes a quality review of random and targeted clinical CVA audits.  
A brief coding/auditing assessment may be included as part of the interview process
Estimated salary range is $60,100 to $98,700 
For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits

Responsibilities

Apply clinical judgment for DRG audits to ensure accuracy of inpatient DRG coding 

Responsible for reviewing the accuracy and consistency of clinical DRG auditing auditors to ensure audits are appropriately marked for findings and no findings 

Mentor Clinical DRG auditors 

Recommend process changes to improve quality and performance 

Communicate with peers and management 

Provide root cause analysis on errors 

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

Qualifications
Current Registered Nurse license 

5 plus years experience working with clinical validation audits 

 
Knowledge and Skills:  

Superior auditing and monitoring skills  

Ability to mentor and instruct  

Excellent decision making skills and sound judgment  

Thorough understanding of medical terminology and human physiology  

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 

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 
 
The posted base salary range is the hiring base salary range for this role. 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.
 

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 is the indispensable partner for leading businesses in data-led industries such as insurance, banking and financial services, healthcare, retail and logistics. We bring a unique combination of data, advanced analytics, digital technology and industry expertise to help our clients turn data into insights, streamline operations, improve customer experience, and transform their business. Our partnerships with clients are built on a foundation of collaboration – and we’ve been chosen as a partner by nine of the top ten leading US insurance companies, nine of the top 20 global banks, and six of the top ten US health care payers. We function as one team to make your goals our goals, whether that’s unlocking the value of generative AI or embedding analytics into workflows that reduce risk or power your growth. Clients choose EXL as their transformation partner for many reasons. Our geographic diversity make talent all over the world instantly accessible. Digital accelerators enable unmatched speed-to-value, letting you realize results fast. It’s our people that truly set us apart, though, including the 1,500 data scientists we have dedicated to our generative AI practice. And our more than twenty years of experience in delivering business services, garnering stellar client references, and maintaining a solid balance sheet are reassuring to our C-suite clients. Find out for yourself why clients, employees, and analysts think we’re some of the best in the business. Contact us to see how we can help you achieve your goals.

To apply: https://weworkremotely.com/remote-jobs/exl-quality-analyst-clinical-validation-auditor-cva-healthcare

Interview prep

Walk in with sharper answers.

Use this as a quick practice sheet before you speak with the employer.

Mid
Technology & IT Business Development Data Analysis Human Resources Operations Remote Collaboration Mid level

Likely questions

  1. Tell us about work you have done that is close to the Quality Analyst - Clinical Validation Auditor (CVA), Healthcare role.
  2. How would you approach your first 30 days at EXL?
  3. Which of Business Development, Data Analysis and Human Resources have you used recently, and what did it help you achieve?
  4. Describe a time you solved a problem without waiting to be told exactly what to do.
  5. How do you handle busy days, changing priorities, or pressure at work?

Prepare before the call

  • A recent example that proves your experience with Business Development, Data Analysis and Human Resources.
  • One short story with a problem, your action, and the result.
  • Two examples that show the strengths listed on your CV.
  • A clear reason why this role and company interest you.
  • Your availability, preferred work style, and salary expectations.

Ask them

  • What would success look like in the first 90 days?
  • What are the main problems this hire should help solve?
  • How does the team give feedback and measure good work?
  • What does a normal working week look like for this role?
Practice line

I am interested in the Quality Analyst - Clinical Validation Auditor (CVA), Healthcare role because I can bring practical experience in Business Development, Data Analysis and Human Resources, learn the team quickly, and contribute to the outcomes EXL needs from this hire.

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