Home Health Auditor III
Job Description:
- Audit Home Health medical records to validate or revise billed services based on CMS guidelines
- Apply clinical judgment and coding expertise to identify overpayments and ensure proper reimbursement
- Document audit findings with clarity, professionalism, and precision using OASIS, ICD-10 CM, and CMS Home Health guidelines
- Utilize industry-leading tools like Decision Health, Webstrat, and proprietary EXL platforms to complete your work efficiently
- Identify audit trends and help drive improvements that benefit both providers and patients
- Stay current on the latest clinical and reimbursement guidelines and deliver work that meets or exceeds productivity and quality benchmarks
Requirements:
- LPN or Registered Nurse (Associate’s or Bachelor’s degree preferred)
- 3+ years of acute care nursing experience, with strong consideration for candidates holding OASIS or Coding certifications
- Prior experience in Home Health auditing is essential
- Deep knowledge of PDGM and PPS payment methodologies
- Proficiency in auditing and coding tools (Decision Health, ICD-10, Webstrat)
- Strong command of Microsoft Office, including Excel, Word, and OneNote
- Exceptional time management, attention to detail, and independent work ethic
- Clear and confident communicator – both in writing and verbally
- Passion for improving healthcare through teamwork, collaboration, and continuous learning
Benefits:
- Competitive benefits package, including healthcare, vision, dental, and 401(k) options
- A strong culture of collaboration, support, and inclusivity
- Mentorship and career development programs to help you grow professionally
- Hands-on experience with top-tier clients in the healthcare industry
- A fast-paced, innovative environment with a team of industry-leading experts
Apply To this Job Company : EXL Salary : 70K–80K a year