Senior Executive - Quality Auditor

• Perform detailed auditing of coded medical records as per client-specific guidelines to ensure accuracy and completeness.

  • Meet defined quality benchmarks (including 98% ATA quality) and productivity targets while maintaining required audit samples.
  • Record audit findings, provide structured and real-time feedback to coders, and conduct error feedback sessions for improvement.
  • Maintain and update all required logs (productivity, audit, clarification, error logs) on a daily basis.
  • Follow all project protocols, procedures, and instructions, ensuring compliance with EXL policies, HIPAA, and confidentiality standards.
  • Collaborate with managers for issue resolution, clarifications, and continuous process improvement initiatives.

Qualifications:

• Graduate in Life science, Paramedical (BPT, BOT, B.SC Nursing) preferred
• Experience: 4 to 6 years of experience with HCC Risk Adjustment
• CRC / CPC / CCS / COC certification - Any one Mandatory

Experience -

• 4 - 6 year of Coding with quality experience
• QC experience

Minimum 1-2 years of experience in a Quality Analyst or Quality Auditing role.

Preferred Qualifications (Desirable Criteria)

Strong proficiency in Microsoft Excel, including trackers, analysis, and reporting.

NA

• Review coded medical records for auditing as outlined per Client specific guideline
• Achieve quality and production targets defined per client project
• Follow all project related protocols, procedures and instructions as documented and instructed by manager
• Update all the logs, i.e. productivity, clarification, audit and error and others as applicable
• Record the feedback as appropriate and provide real time feedback to coders.
• Conducting Error Feedback session with Coders.
• Securing ATA quality at 98%.
• Meeting the defined samples per projects
• Comply with EXL, HIPAA, and other regulations and guidelines related to patient confidentiality and protocols for client information
• Check with Manager for issue resolution and clarification as needed