Durable Medical Equipment (DME) Auditor

As a DME Auditor , you’ll use your deep understanding of Durable Medical Equipment (DME) , Medicare , Medicaid , and commercial reimbursement rules to review professional claims and ensure proper coding and payment. You’ll analyze claims, document your findings clearly, and help our clients recover overpayments—all while making a direct impact on healthcare efficiency.Salary range $50,000 - $65,000Up to 10% travel may be required.For more information on benefits and what we offer please visit us at us-careers-and-benefits Responsibilities Review medical records to verify services were provided as billed for Hospital Bill Audit reviews. Identify overcharges, undercharges and unbundled items. Identify unbundled items on the itemized bill specific to payer Unbundling Guidelines and provide references and rationale to support review findings. Scheduling Audits: Manage inventory and schedule audits timely by contacting the provider to schedule date and time to perform audits. Report any problems in the audit process to Manager for resolution. Comply with HIPAA and other regulations regarding the confidentiality of patient information. Conduct all job functions and responsibilities in accordance with all company Compliance, Information Security and Regulatory policies, procedures and programs. Qualifications Three or more years of experience in claims processing, medical billing, or auditing —with a strong focus on Durable Medical Equipment (DME). In-depth knowledge of HCPCS codes and reimbursement policies. Proven ability to read and interpret contract language and fee schedules. Intermediate Excel and Word skills, with a solid grasp of basic math. Preferred Qualifications Preferably certified with RHIA, CPC, or similar credentials (multiple credentials are a plus). Bonus if you’ve used: FACETS, NASCO, Encoder Pro, TrueCode, 3M, Webstrat, Pricers. Professional Qualifications Comfortable working independently in a remote environment. Strong written and verbal communication, time management, and analytical skills. The posted base salary range is the hiring base salary range for this role. Final offers are based on several factors, including: the candidate's skills and experience, internal pay equity, work location, market conditions for the role, and the specific scope and responsibilities of the position. EXL (NASDAQ: EXLS) is a leading data analytics and digital operations and solutions company. We partner with clients using a data and AI-led approach to reinvent business models, drive better business outcomes and unlock growth with speed. EXL harnesses the power of data, analytics, AI, and deep industry knowledge to transform operations for the world’s leading corporations in industries including insurance, healthcare, banking and financial services, media and retail, among others. EXL was founded in 1999 with the core values of innovation, collaboration, excellence, integrity and respect. We are headquartered in New York and have more than 54,000 employees spanning six continents. For more information, visit never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates. EXL will only extend a job offer after a candidate has gone through a formal interview process with members of EXL’s Human Resources team, as well as our hiring managers.EXL is the indispensable partner for leading businesses in data-led industries such as insurance, banking and financial services, healthcare, retail and logistics. We bring a unique combination of data, advanced analytics, digital technology and industry expertise to help our clients turn data into insights, streamline operations, improve customer experience, and transform their business. Our partnerships with clients are built on a foundation of collaboration – and we’ve been chosen as a partner by nine of the top ten leading US insurance companies, nine of the top 20 global banks, and six of the top ten US health care payers. We function as one team to make your goals our goals, whether that’s unlocking the value of generative AI or embedding analytics into workflows that reduce risk or power your growth. Clients choose EXL as their transformation partner for many reasons. Our geographic diversity make talent all over the world instantly accessible. Digital accelerators enable unmatched speed-to-value, letting you realize results fast. It’s our people that truly set us apart, though, including the 1,500 data scientists we have dedicated to our generative AI practice. And our more than twenty years of experience in delivering business services, garnering stellar client references, and maintaining a solid balance sheet are reassuring to our C-suite clients. Find out for yourself why clients, employees, and analysts think we’re some of the best in the business. Contact us to see how we can help you achieve your goals. #J-18808-Ljbffr EXL