Quality Analyst, Lead Assistant Manager

EXL

Quality Analyst overseeing clinical audit program for home health services at EXL. Ensuring accuracy in clinical coding audits and developing audit feedback sessions with clinical staff.

Posted 7/2/2026full-timeRemote • 🇺🇸 United StatesSenior💰 $60,100 - $98,700 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates extensive experience in clinical auditing and coding within home health, ensuring compliance with federal and state regulations. Possesses strong decision-making abilities and excellent communication skills to mentor staff and enhance audit accuracy.

Highest-signal resume keywords

Registered Nurse LicenseHome Health ExperienceOASIS CertificationICD-10 Coding KnowledgeClinical Auditing Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical CodingAuditingOASIS Claims ReviewICD-10 CodingQuality ReviewMedical TerminologyHuman PhysiologyCompliance ReviewData ExtractionTraining Development

Soft Skills

Decision-MakingCommunicationMentoringOrganizational SkillsAdaptability

Tools & Technologies

Microsoft Excel

Certifications & Qualifications

OASIS CertificationCoding Certification

Industry Keywords

CMS GuidelinesHome Health Coverage GuidelinesHH PPS ReimbursementSOC/ROC/Recert AssessmentsOverpayment Issues

About the role

Key responsibilities & impact

Oversees work performed by the home health clinical audit program to ensure that EXL’s standard of accuracy is met.
Undertakes quality review of random and targeted clinical coding audits, involving and consulting with clinical auditors, clinicians, and managers to enhance the accuracy and completeness of audits performed.
Develops audit feedback sessions to all staff from routine internal audit, identifying general training trends and requirements.

Requirements

What you’ll need

Registered Nurse with a license in good standing in the state that you reside
7 plus years of home health experience
Previous auditing experience
OASIS certification and/or coding certification preferred
Experience, or equivalent, coding or auditing of Home Health OASIS and non-OASIS claims
Ability to review SOC/ROC/Recert assessments to ensure appropriateness, completeness, and compliance with federal and state regulations and organization policy
Ability to ensure appropriate ICD-10 coding and sequencing as it relates to the patient’s medical condition
Knowledge of CMS/Chapter 7 Home Health Coverage Guidelines, National Coverage Guidelines, and HH PPS Reimbursement
Ability to pinpoint, extract, and use record information to cite issues related to the overpayment
Assists the program/team in returning client overpayments and achieving internal revenue goals
Superior clinical auditing and monitoring skills
Excellent decision-making skills and sound judgement
Thorough understanding of medical terminology and human physiology
Strong technical knowledge and ability to learn new systems quickly
Excellent verbal and written communication skills
Ability to mentor and instruct through audits
Strong organizational skills and high attention to detail
Demonstrated flexibility and adaptability
Ability to work in a team environment and independently as needed
Working knowledge of Microsoft Excel

Benefits

Comp & perks

For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits