Senior Executive - Clinical Auditor

EXL · Chennai, IN

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• 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...

• Clinical knowledge
• Document Auditing
• Team Coordination Ability to multi-task
• analysis skill