EXL—Senior Executive - Coding Auditor

Job description

Description: - Perform accurate CPT / ICD-10-CM coding with appropriate modifier usage - Review and analyze denied claims and identify root causes - Initiate outbound calls to provider offices for denial clarification and resolution - Document call outcomes and update claim status in systems - Ensure timely follow-up on pending claims to maximize reimbursement - Adhere to client-specific guidelines and project requirements - Maintain quality and productivity benchmarks as defined by the client - Prepare reports and track performance using MS Excel / PPT Requirements: Qualifications & Skills (8–10 Points) - Denial Experience (EM + Surgery) and 3+ Years after CPC/CCS is not mandatory - Strong knowledge of CPT, ICD-10-CM, modifiers, E&M, and surgical coding - Good understanding of Anatomy & Physiology - Mandatory certification: CPC or CCS (No Apprentice credentials) - Excellent communication skills with neutral accent (mandatory for calling role) - Prior experience in voice process is an added advantage - Ability to work in Eastern (US) shift - High energy level with proactive and spontaneous approach - Strong analytical and problem-solving skills - Proficiency in MS Office (Excel & PowerPoint) - Ability to understand client requirements and deliver accordingly Telecommuting Requirement - Must be comfortable working in a telecommuting (remote/hybrid) setup as per business requirements - Ensure stable internet connectivity and a distraction-free work environment for both coding and calling responsibilities q Responsibilities: - Perform accurate CPT / ICD-10-CM coding with appropriate modifier usage - Review and analyze denied claims and identify root causes - Initiate outbound calls to provider offices for denial clarification and resolution - Document call outcomes and update claim status in systems - Ensure timely follow-up on pending claims to maximize reimbursement - Adhere to client-specific guidelines and project requirements - Maintain quality and productivity benchmarks as defined by the client - Prepare reports and track performance using MS Excel / PPT