Company Overview and Culture 

EXL (NASDAQ: EXLS) is a global analytics and digital solutions company that partners with clients to improve business outcomes and unlock growth. Bringing together deep domain expertise with robust data, powerful analytics, cloud, and AI, we create agile, scalable solutions and execute complex operations for the world’s leading corporations in industries including insurance, healthcare, banking and financial services, media, and retail, among others. Focused on creating value from data for driving faster decision-making and transforming operating models, EXL was founded on the core values of innovation, collaboration, excellence, integrity and respect. Headquartered in New York, our team is over 40,000 strong, with more than 50 offices spanning six continents. For information, visit www.exlservice.com.

For the past 20 years, EXL has worked as a strategic partner and won awards in its approach to helping its clients solve business challenges such as digital transformation, improving customer experience, streamlining business operations, taking products to market faster, improving corporate finance, building models to become compliant more quickly with new regulations, turning volumes of data into business opportunities, creating new channels for growth and better adapting to change. The business operates within four business units: Insurance, Health, Analytics, and Emerging businesses. 

EXL Health is hiring a Professional Coding SME. This is a remote, work from home opportunity.

Responsibilities:

• The successful candidate will lead a team of coding auditors, reviewing selected professional claims for appropriate coding and reimbursement.
• Possess the coding skill set and experience to lead a team of experienced  coders by demonstrating mastery of the coding guidelines, CPT classification systems, billing and reimbursement process and support tools.
• This candidate will have a strong background in professional E&M coding
• This candidate will be able to evaluate client data and review payment methodologies to determine the auditing ability of the program.
• The professional coding SME is expected to actively participate in the selections process initiatives, monitor the program performance, review results and fine tune the selections queries working with the selections analytics team. In addition, the clinical specialist will ensure audit staff is trained, aligned, and well able to achieve established goals and performance requirements.
• Will ensure all providers disputes are reviewed and effectively addressed.
• Provide daily support and direction of program activities.
• Contact and explanation of results to the provider community
• Participate in internal meetings to collaborate audit decisions and work towards maintaining and growing the audit program.
• Candidate will work with the overall clinical manager to ensure program is flowing as expected and identify any potential barriers or areas of opportunity

Qualifications:

• CCS-P- Certified Coding Specialist Physician, CPC – Certified Procedural Coder. Noteworthy CCS - Certified Coding Specialist.
• RHIT - Registered Health Information Technologist.
• 10 plus years’ experience with professional auditing/coding
• Strong background in surgery auditing for multiple specialties
• Expert knowledge of ICD-9, ICD-10, CPT and HCPCS coding guidelines.  
• Experience with encoder tools (TrueCode, 3M, Webtrat, Pricers).
• Possess strong leadership and organizational skills, with 3-5 years of supervisory experience, the ability to develop work plans, action plans, and standard operating procedures. To include the ability to build a strong teamwork environment of inclusiveness and support.
• Excellent verbal / written communication skills, with the ability to lead training. Team calls, etc.
• Experience with need programs such as: Excel, PowerPoint, Outlook, and Word.