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Hiring companyEXL

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Senior Executive - Clinical Auditor

Chennai, Tamil Nadu, India Full-time Hybrid

About the role

EXL seeks a Senior Executive - Clinical Auditor in Chennai to review medical claims against patient records for accuracy and compliance. The role involves identifying billing discrepancies, conducting best practice audits, and ensuring adherence to CMS guidelines. This hybrid position requires a Registered Nurse with strong clinical knowledge and auditing skills.

What you’ll do

  • Review and audit medical claims against patient medical records
  • Identify discrepancies between clinical documentation and billed services
  • Perform detailed clinical reviews to validate diagnosis and procedures
  • Ensure compliance with CMS guidelines and payer policies
  • Conduct best practice audits to identify coding inaccuracies
  • Provide structured findings and audit reports with recommendations
  • Collaborate with coding and billing teams to resolve findings
  • Monitor audit trends and support quality assurance initiatives

What you’ll bring

  • Bachelor’s degree in nursing
  • Active State Nursing certification
  • Minimum 3 years of clinical/hospital experience

Skills

Clinical knowledgeDocument AuditingTeam CoordinationAnalysis SkillMedical TerminologyCMS ComplianceCommunication SkillsQuality Assurance

Education

Bachelor’s degree in nursing

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