Clinical QA Analyst – DRG Auditing Career at EXL in Columbus
Career & Market Insight
This is a senior-level clinical quality role requiring an active RN license plus 5+ years of CVA (Clinical Validation Audit) experience — a niche but high-demand specialization in healthcare revenue cycle management.
Compensation: The $60,100–$98,700 range is somewhat below market for experienced RN-level clinical auditors, where senior roles at large health systems or payers often reach $95K–$120K. The wide range suggests room to negotiate based on experience, especially for candidates with strong DRG expertise.
Skills You'll Develop:
- Clinical documentation improvement (CDI) and DRG auditing at scale
- Quality oversight and auditor mentoring — a path toward management
- Root cause analysis and process improvement in healthcare operations
- Experience with a large analytics-driven BPO, adding enterprise-level exposure
Career Path Signals: This role sits at the intersection of clinical expertise and data/analytics operations — a growing space as AI and automation reshape healthcare coding. EXL's scale (54,000+ employees, NASDAQ-listed) offers stability and potential internal mobility into leadership or analytics roles.
Green Flags: Remote work, established company with strong healthcare client base, mentorship responsibility that signals career advancement potential.
Red Flags: Compensation may be below market for seasoned auditors; limited details on PTO, advancement criteria, or team structure. The broad "other duties as assigned" language warrants clarification during interviews.
Headquarters: United States
URL: https://fa-ewjt-saasfaprod1.fa.ocs.oraclecloud.com:443/hcmUI/CandidateExperience/
This is a remote office opportunity. The Quality Analyst oversees work performed by the Clinical CVA auditors to ensure that EXL's standard of accuracy is met. The analyst undertakes a quality review of random and targeted clinical CVA audits.
A brief coding/auditing assessment may be included as part of the interview process.
Estimated salary range is $60,100 to $98,700.
For more information on benefits and what we offer, please visit: https://www.exlservice.com/us-careers-and-benefits
Responsibilities
- Apply clinical judgment for DRG audits to ensure accuracy of inpatient DRG coding
- Review the accuracy and consistency of clinical DRG auditing auditors to ensure audits are appropriately marked for findings and no findings
- Mentor Clinical DRG auditors
- Recommend process changes to improve quality and performance
- Communicate with peers and management
- Provide root cause analysis on errors
- Perform other duties as assigned
- Conduct all job functions and responsibilities in accordance with all company Compliance, Information Security, and Regulatory policies, procedures, and programs
Qualifications
- Current Registered Nurse license
- 5+ years of experience working with clinical validation audits
Knowledge and Skills:
- Superior auditing and monitoring skills
- Ability to mentor and instruct
- Excellent decision-making skills and sound judgment
- Thorough understanding of medical terminology and human physiology
- Strong technical knowledge and ability to learn new systems quickly
- Excellent oral/presentation and written communication skills
- Ability to complete tasks efficiently and resolve problems within set timelines
- Strong organizational skills and attention to detail
- Ability to work in a team environment and independently as needed
- Demonstrated flexibility and adaptability
- Must be able to work under deadlines and utilize independent decision-making skills in a wide variety of situations
- Requires a high degree of accuracy in the performance of varied responsibilities
- Personal computer skills required; must be self-motivated to complete work in a timely manner to meet deadlines
- Strong interpersonal skills required
The posted base salary range is the hiring base salary range for this role. Final offers are based on several factors, including the candidate's skills and experience, internal pay equity, work location, market conditions for the role, and the specific scope and responsibilities of the position.
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 54,000 employees spanning six continents. For more information, visit www.exlservice.com.
EXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates. EXL will only extend a job offer after a candidate has gone through a formal interview process with members of EXL's Human Resources team, as well as our hiring managers.
Frequently Asked Questions
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