Quality Analyst IV - Diagnosis-Related Group (DRG), Healthcare

About the position EXL Health is seeking an experienced Clinical Diagnosis-Related Group (DRG) Quality Analyst for a remote office opportunity. The Quality Analyst IV will oversee the work performed by Clinical DRG auditors to ensure EXL’s standard of accuracy is met. This role involves conducting quality reviews of random and targeted clinical DRG audits. A brief coding/auditing assessment may be part of the interview process. EXL is a leading data analytics and digital operations and solutions company that partners with clients using a data and AI-led approach to reinvent business models, drive better business outcomes, and unlock growth with speed. EXL was founded in 1999 with core values of innovation, collaboration, excellence, integrity, and respect. The company is headquartered in New York and has over 54,000 employees spanning six continents. EXL is an indispensable partner for leading businesses in data-led industries such as insurance, banking and financial services, healthcare, retail, and logistics. They bring a unique combination of data, advanced analytics, digital technology, and industry expertise to help clients turn data into insights, streamline operations, improve customer experience, and transform their business. EXL has partnerships with 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. They function as one team to make client goals their own, whether that's unlocking the value of generative AI or embedding analytics into workflows that reduce risk or power growth. Clients choose EXL as their transformation partner for many reasons, including their geographic diversity for accessible talent, digital accelerators for speed-to-value, their people (including 1,500 data scientists dedicated to their generative AI practice), over twenty years of experience, stellar client references, and a solid balance sheet.

Responsibilities

• Oversees work performed by Clinical DRG auditors to ensure that EXL’s standard of accuracy is met.
• Undertakes a quality review of random and targeted clinical DRG audits.

Requirements

• Experienced Clinical Diagnosis-Related Group (DRG) Quality Analyst.

Nice-to-haves

• A brief coding/auditing assessment may be included as part of the interview process.

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