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 Apply tot his job Apply To this Job