Quality Analyst – Diagnosis-Related Group, Healthcare

EXL

Quality Analyst overseeing DRG audits to ensure accuracy for EXL Health. Requires clinical validation auditing experience and decision-making skills in a remote setting.

Posted 7/2/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $70,000 - $110,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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

Demonstrates extensive experience in clinical validation audits, with a strong focus on accuracy in DRG coding and auditing processes. Capable of mentoring teams, providing root cause analysis, and recommending process improvements while adhering to compliance and regulatory standards.

Highest-signal resume keywords

Clinical Validation AuditsDRG Coding AccuracyMentoring SkillsAuditing and Monitoring SkillsMedical Terminology Knowledge

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Clinical Validation AuditsDRG CodingRoot Cause AnalysisAuditing SkillsMedical TerminologyHuman Physiology KnowledgeDecision MakingOrganizational SkillsAttention to DetailTechnical Knowledge

Soft Skills

MentoringCommunication SkillsProblem SolvingFlexibilityInterpersonal Skills

Tools & Technologies

Personal Computer Skills

Industry Keywords

ComplianceRegulatory PoliciesQuality ReviewPerformance Improvement

About the role

Key responsibilities & impact

Oversee work performed by the Clinical DRG auditors to ensure that EXL’s standard of accuracy is met
Undertake a quality review of random and targeted clinical DRG audits
Apply clinical judgment for DRG audits to ensure accuracy of inpatient DRG coding
Responsible for reviewing 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

Requirements

What you’ll need

Minimum 5 years experience working with clinical validation audits
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. Must be able to 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

Benefits

Comp & perks

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