Audit Coordinator I, Post Audit – Healthcare
Virtual Req #27280
Wednesday, November 6, 2024
Company Overview and Culture
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 55,000 employees spanning six continents. For more information, visit http://www.exlservice.com.
About EXL Health
We leverage Human Ingenuity and domain expertise to help clients improve outcomes, optimize revenue and maximize profitability across the healthcare ecosystem. Technology, data and analytics are at the heart of our solutions. We collaborate closely with clients to transform how care is delivered, managed and paid.
EXL Health combines deep domain expertise with analytic insights and technology-enabled services to transform how care is delivered, managed, and paid. Leveraging Human Ingenuity, we collaborate with our clients to solve complex problems and enhance their performance with nimble, scalable solutions. With data on more than 260 million lives, we work with hundreds of organizations across the healthcare ecosystem.
We help payers improve member care quality and network performance, manage population risk, and optimize revenue while decreasing administrative waste and reducing health claim expenditures. We help Pharmacy Benefit Managers (PBMs) manage member drug benefits and reduce drug spending while maintaining quality. We help provider organizations proactively manage risk, improve outcomes, and optimize network performance. We provide Life Sciences companies with enriched data, insights through advanced analytics and data visualization tools to get the right treatment to the right patient at the right time.
Post Audit – Audit Coordinator I
The Audit Coordinator I supports all post audit functions by ensuring accuracy of audit invoices, itemized bills, and audit fees. The Audit Coordinator I is responsible for handling calls to and from providers, sending letters to the provider, moving the audits through the audit workflow system (EXL mine) generating and submitting finding files and invoices to the clients.
Responsibilities:
- Perform quality review of client letters, ensuring accuracy of format, spelling and grammar.
- Generating and submitting Finding Files to the client timely and accurately.
- Ensure completed audits are invoice timely and accurately.
- Ensure that all invoicing for medical records, itemized bills and audit fees are handled and processed timely and accurately.
- Prepare reports and any ad hoc requests from Manager.
- Manage group emails.
- Provider collections
- Work with internal departments to resolve invoicing and collection issues.
- Responds to accounting or billing inquiries from providers.
- Serve as a liaison for internal and external clients, including screening phone calls, facilitating client communications to the appropriate client leader and following up with clients, when appropriate.
- Become familiar with client reports and internal reports and assist in their preparation.
- Interact with internal staff and client to re-price audits with validation/audit findings.
- Participate in external operational conference calls with the client (where applicable).
- Ensure all audit issues are documented in the applicable audit program Audit System.
- Escalate issues to management and handle for Follow Up action as needed.
- Provide back-up assistance to other Audit Coordinators as needed.
- Provide back-up scanning assistance to correspondence emailing as needed.
- Comply with HIPAA and other regulations regarding confidentiality of information.
- Other duties as assigned to support the audit process and/or company-wide programs.
Required:
- High School Diploma – Associate degree or relevant certification is a plus
- Solid knowledge of Microsoft Office necessary, especially Excel, Word, and Outlook
- 1 years’ minimum experience working as a Claims Analyst or Claims Auditor in a managed care setting (hospital, health plan or physician office)
- Highly organized, detail oriented and solid problem-solving skills
- Able to make recommendations to improve and streamline processes to make more efficient
- Ability to positively and comfortably handle and prioritize multiple tasks in a fast-paced environment with focused attention to detail
- High level of integrity and confidentiality
- Possesses time management skills; exhibits solid ability to prioritize work and perform multi-tasks.
- Basic knowledge of medical claims
- Prior coding or medical claims experience or training
- Strong written and verbal communication skills
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.
EEO/Minorities/Females/Vets/Disabilities
To view our total rewards offered click here —> https://www.exlservice.com/us-careers-and-benefits
Base Salary Range Disclaimer: The base salary range represents the low and high end of the EXL base salary range for this position. Actual salaries will vary depending on factors including but not limited to: location and experience. The base salary range listed is just one component of EXL’s total compensation package for employees. Other rewards may include bonuses, as well as a Paid Time Off policy, and many region specific benefits.
Please also note that the data shared through the job application will be stored and processed by EXL in accordance with the EXL Privacy Policy.
Application & Interview Impersonation Warning – Purposely impersonating another individual when applying and / or participating in an interview in order to obtain employment with EXL Service Holdings, Inc. (the “Company”) for yourself or for the other individual is a crime. We have implemented measures to deter and to uncover such unlawful conduct. If the Company identifies such fraudulent conduct, it will result in, as applicable, the application being rejected, an offer (if made) being rescinded, or termination of employment as well as possible legal action against the impersonator(s).
EXL may use artificial intelligence to create insights on how your candidate information matches the requirements of the job for which you applied. While AI may be used in the recruiting process, all final decisions in the recruiting and hiring process will be taken by the recruiting and hiring teams after considering a candidate’s full profile. As a candidate, you can choose to opt out of this artificial intelligence screening process. Your decision to opt out will not negatively impact your opportunity for employment with EXL.