[Hiring] Outpatient Trainer @EXL

Role Description

The Outpatient Trainer plays a critical role in improving audit consistency, accuracy, and completeness by translating audit outcomes into effective learning experiences. This role supports the Outpatient Audit program by delivering and reinforcing training to improve coding accuracy and audit quality in alignment with EXL standards.

• Leverages findings from random and targeted outpatient coding audits to identify learning gaps and deliver targeted training, refreshers, and performance support focused on medical documentation review and coding guideline application.
• Partners closely with Quality Analysts, Auditors, and Subject Matter Experts to ensure training content reflects current outpatient coding requirements and audit expectations.

Responsibilities

• Deliver onboarding training for new outpatient coders and refresher training for tenured coders.
• Develop and maintain training content and modules related to medical coding and billing, including ICD-10-CM, CPT, E/M coding, Business of Medicine, edit resolution, and revenue cycle concepts.
• Analyze coding errors and audit trends to identify root causes and deliver targeted training or remediation.
• Mentor outpatient coders and provide coaching and performance feedback as needed.
• Conduct quality reviews related to initial audits and appeals to support training insights and skill reinforcement.
• Identify opportunities beyond standard audit findings that may result in additional recoveries and incorporate learnings into training.
• Maintain current knowledge of ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding guidelines.
• Track and consolidate learner performance data from quizzes, exams, and assessments, and present summarized insights during weekly meetings.
• Perform all responsibilities in accordance with company compliance, information security, and regulatory requirements.
• Perform other duties as assigned.

Qualifications

• Bachelor’s degree or equivalent.
• CCS or CPC certified.
• Minimum 5 years coding experience: Professional or hospital coding with thorough understanding of ICD-10 Coding; HCPCS/CPT coding systems; Medicare Outpatient Prospective Payment System (OPPS), and Ambulatory Payment Classification (APC).
• Experience with and expertise with Medicare Local Coverage Determinations (LCD) and National Coverage Determinations (NCD).

Knowledge and Skills

• Demonstrated skill in training facilitation, including delivering instructor-led, virtual, and blended training to adult learners.
• Strong working knowledge of outpatient clinical coding, including CPT, ICD-10-CM, modifiers, and documentation requirements.
• Proficient in modifier application following appropriate Medicare and NCCI guidelines.
• Ability to code a wide variety of complex outpatient services such as interventional radiology, ambulatory surgery, emergency room and observation.
• Ability to explain complex coding guidelines and audit concepts in a clear, engaging, and practical manner.
• Strong communication and facilitation skills, with the ability to engage learners and manage group dynamics in a virtual environment.
• Analytical skills to identify knowledge gaps, recurring errors, and training opportunities based on audit trends.
• Ability to work collaboratively with Quality, Audit, and SME partners in a cross-functional, remote environment.
• Strong organizational and time-management skills to manage multiple training initiatives and deadlines.
• Comfort using technology-based training and collaboration tools (e.g., virtual meeting platforms, LMS, MS Teams).
• Personal computer skills required. Experience with: Excel, PowerPoint, Outlook, and Word.

Benefits

• EXL Health offers an exciting, fast-paced, and innovative environment, which brings together a group of sharp and entrepreneurial professionals who are eager to influence business decisions.
• Opportunity to work closely with highly experienced, world-class Healthcare consultants.
• Learn many aspects of businesses that our clients engage in, along with effective teamwork and time-management skills.
• Guidance/coaching through our mentoring program wherein every junior-level employee is assigned a senior-level professional as an advisor.
• Unique experiences gathered at EXL Health set the stage for further growth and development in our company and beyond.