Clinical Validation Auditor, Auditor III

EXL

. Review inpatient medical records to verify that DRG codes are supported by documentation .

Posted 10/26/2026full-timeRemote • United StatesMid-LevelSenior💰 $60,100 - $98,700 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in DRG coding and auditing, with a strong focus on clinical documentation accuracy and compliance. Proficient in using industry tools and maintaining up-to-date knowledge of clinical guidelines and trends.

Highest-signal resume keywords

Registered Nurse (RN) LicenseDRG Audits ExperienceClinical Documentation ImprovementCCS CertificationExcel Proficiency

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

DRG CodingClinical KnowledgeCoding ValidationDocumentation ReviewReadmission Reviews

Soft Skills

Clear CommunicationTime ManagementFocus While Working Remotely

Tools & Technologies

3MWebstratExcelWordOneNote

Certifications & Qualifications

CCSRHIARHIT

Industry Keywords

Acute Care ExperienceInpatient Medical RecordsClinical GuidelinesDRG RulesIndustry Trends

About the role

Key responsibilities & impact

Review inpatient medical records to verify that DRG codes are supported by documentation
Apply clinical and coding knowledge to identify inaccuracies and potential overpayments
Document findings in clear, professional language, explaining the rationale for reviews
Use industry tools such as 3M or Webstrat to support audit decisions
Work independently while meeting productivity and quality goals
Stay current with clinical guidelines, DRG rules, and industry trends

Requirements

What you’ll need

Registered Nurse (RN) with an active license
5+ years of acute care experience (hospital setting preferred)
Experience in DRG audits or coding validation is a big plus
Certifications such as CCS, RHIA, or RHIT are a plus
Knowledge of readmission reviews (PPR) is a plus
Ability to explain clinical decisions clearly and professionally
Ability to manage time and stay focused while working remotely
Comfortable using Excel, Word, and OneNote
Bachelor's Degree

Benefits

Comp & perks

Fully remote work
Up to 10% annual travel for team meetings and limited client onsite engagements
Supportive, high-performing team environment
Opportunity to grow in healthcare analytics
Training on 3M or Webstrat if needed
Benefits information available at https://www.exlservice.com/us-careers-and-benefits