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Full-time
bachelor degree
Posted 14h ago
~40 hrs/week
Responsibilities
The Senior Executive - Clinical Auditor is responsible for reviewing and auditing medical claims against patient records to ensure documentation accuracy and regulatory compliance. They collaborate with coding and billing teams to resolve discrepancies and identify opportunities for process improvement.
Requirements
Candidates must hold a Bachelor's degree in nursing and possess an active State Nursing certification. A minimum of 3 years of clinical or hospital experience is mandatory for this role.
Full job description
Review and audit medical claims against patient medical records to ensure accuracy and completeness of documentation.
Identify discrepancies between clinical documentation and billed services, highlighting variances and potential billing errors.
Perform detailed clinical reviews to validate diagnosis, procedures, and level of care in accordance with industry standards.
Ensure compliance with CMS guidelines, payer policies, and regulatory requirements during claim review processes.
Conduct best practice audits to identify documentation gaps, coding inaccuracies, and revenue leakage opportunities.
Provide structured findings and audit reports with clear recommendations for corrective action and process improvement.
Collaborate with coding, billing, and provider teams to resolve audit findings and support accurate claim submissions.
Monitor trends in audit results and identify recurring issues requiring targeted education or intervention.
Support quality assurance initiatives by maintaining audit accuracy benchmarks and meeting productivity standards.
Participate in continuous improvement activities, including updates on CMS regulations, clinical guidelines, and payer policy changes.
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.
Offices: 320 Park Avenue, 29th Floor, New York, NY 10022, US · 10 Exchange Pl, Jersey City, NJ 07302, US
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How many Finance & Accounting jobs are open in Chennai, India right now?
There are currently 1,513 open finance & accounting positions in Chennai, India listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Finance & Accounting roles in Chennai, India?
Companies currently hiring include Accenture, Kotak Mahindra Bank, U.S. Bank, Citi, IDFC FIRST Bank, among others. Browse the listings above to see every active employer.
Are there remote or hybrid Finance & Accounting jobs in Chennai, India?
Yes — 286 of the 1513 open finance & accounting positions offer remote or hybrid work (17 remote, 269 hybrid).
How do I apply for Finance & Accounting jobs in Chennai, India?
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.