Logo for EXL

Outpatient Auditor II

Role overview

Summary

This role focuses on auditing outpatient claims to ensure coding accuracy and compliance with regulatory standards. You will work remotely with EXL Health's auditing team, supporting various stakeholders in the healthcare system.

Qualifications

  • Deep expertise in infusion services, complex surgeries, interventional radiology, and hospital-based outpatient care.
  • Strong commitment to coding accuracy and regulatory compliance.
  • In-depth knowledge of CPT coding and APC reimbursement.
  • Experience in outpatient auditing.
  • Certification as an Outpatient Auditor.

Responsibilities

  • Review outpatient claims across various clinical specialties.
  • Validate billed CPT codes and identify discrepancies.
  • Ensure adherence to outpatient regulatory guidelines and industry standards.
  • Support providers, payers, and patients in achieving appropriate reimbursement.

Key facts

Hard skills

Other skills

  • Detail Oriented

About the company

EXL logo

EXL

  • Outsourcing & BPO
  • XLarge
  • 10,001+
Choosing a digital partner is about more than capabilities — it’s about collaboration and character. Unrealistic overhauls and off-the-shelf products ignore what matters most — your unique needs, culture, goals, and your legacy data and technology environments. At EXL, our collaboration is built on ongoing listening and learning to adapt our methodologies. We’re your business evolution partner—tailoring solutions that make the most of data to make better business decisions and drive more intelligence into your increasingly digital operations. Whether your goals are scaling the use of AI and digital, redesign operating models, or driving better and faster decisions, we’re here to partner with you to help you gain—and maintain—competitive advantage with efficient, sustainable models at scale. Our expertise in transformation, data science, and change management helps make your business more efficient and effective, improve customer relationships and enhance revenue growth. Instead of focusing on multi-year, resource- and time-intensive platform designs or migrations, we look deeper at your entire value chain to integrate strategies with impact. We use our specialization in analytics, digital interventions, and operations management—alongside deep industry expertise — to deliver solutions that help you outperform the competition. At EXL, it’s all about outcomes—your outcomes—and delivering success on your terms. Share your goals with us and together, we’ll optimize how you leverage data to drive your business forward. For more information, visit www.exlservice.com.

Your match analysis

See how your profile stacks up against this role.

We compared the job requirements to your profile to show where you're strong and where you fall short.

Job description

Are you a skilled Outpatient Auditor with deep expertise in infusion services, complex surgeries, interventional radiology, and hospital-based outpatient care? Do you bring a strong commitment to coding accuracy, regulatory compliance, and appropriate reimbursement? If so, EXL Health is excited to welcome you to our remote auditing team!

As a Remote Certified Outpatient Auditor, you’ll apply your in‑depth knowledge of CPT coding, outpatient regulatory guidelines, and APC reimbursement to review outpatient claims across a variety of clinical specialties. Your work will support providers, payers, and patients by validating billed CPT codes, identifying discrepancies, and ensuring adherence to industry standards.

This role is fully remote, with up to 10% annual travel for team meetings and occasional client onsite engagements.

Related jobs

See all Auditor jobs

Other jobs at EXL