Diagnosis-Related Group (DRG) Trainer

Reporting to the Senior Manager of Training, the DRG Trainer plays a critical role in strengthening audit consistency, accuracy, and completeness by translating audit findings into targeted, effective learning experiences. This role supports the audit program by identifying learning gaps and delivering and reinforcing training, refreshers, coaching, and performance support that improves coding accuracy, audit quality, and accelerates trainee readiness for independent production in alignment with EXL standards.

The DRG Trainer partners closely with Quality Analysts, Auditors, and Subject Matter Experts to ensure training content remains current, relevant, and aligned with evolving coding requirements and audit expectations, while driving timely progression through training and successful graduation to operations.

A brief coding/auditing assessment may be included as part of the interview process

Salary for this role is $60,100 - $110,000 plus bonus

For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits

The posted range is the hiring range for this role - a subset of the broader range available to employees over time - and reflects base salary across our national hiring scale. 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. The top of the range is reserved for candidates who notably exceed the requirements; the lower end applies to those with less experience or fewer preferred qualifications. For positions based in higher-cost zones (e.g., California, New York, New Jersey), actual compensation may exceed the posted range; your recruiter will share specifics during the process.

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 www.exlservice.com.

EXL 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.

Qualifications:

• Bachelor's degree or equivalent
• RHIT or RHIA certification required
• CCS or CPC certification required
• 5 plus years relevant DRG and APR DRG coding/auditing experience
• 3 plus years of experience in training, facilitation, or coaching within a coding, audit, or payment integrity setting
• Experience with Medicare Local Coverage Determinations (LCD) and National Coverage Determinations (NCD)
• Experience in coding audit, quality review, or payment integrity programs
• Experience delivering training, coaching, or mentoring new hires and/or tenured staff

Responsibilities:

• Deliver onboarding training for new DRG auditors and refresher training for tenured auditors.
• Develop and maintain training content and modules related to medical coding and billing, including ICD-10-CM, CPT, and HCPCS
• Evaluate training effectiveness; analyze coding audit errors and audit trends to identify root causes and deliver targeted training or remediation.
• Mentor DRG auditors and provide coaching and performance feedback as needed.
• Conduct quality reviews related to initial audits and appeals in order 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.

Knowledge and Skills:

• Demonstrated ability to facilitate instructor-led, virtual, and blended training for adult learners
• Ability to translate complex guidelines and audit concepts into clear, practical, and engaging learning experiences
• Strong analytical skills to identify error patterns, knowledge gaps, and training opportunities based on audit data
• Effective communication and facilitation skills, with the ability to engage learners and manage group dynamics in a virtual environment
• Ability to collaborate cross-functionally with Quality, Audit, and SME partners
• Strong organizational and time management skills to manage multiple priorities and deadlines
• Proficiency with training and collaboration tools (e.g., LMS, MS Teams, Excel, PowerPoint)

Responsibilities:

• Deliver onboarding training for new DRG auditors and refresher training for tenured auditors.
• Develop and maintain training content and modules related to medical coding and billing, including ICD-10-CM, CPT, and HCPCS
• Evaluate training effectiveness; analyze coding audit errors and audit trends to identify root causes and deliver targeted training or remediation.
• Mentor DRG auditors and provide coaching and performance feedback as needed.
• Conduct quality reviews related to initial audits and appeals in order 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.

Knowledge and Skills:

• Demonstrated ability to facilitate instructor-led, virtual, and blended training for adult learners
• Ability to translate complex guidelines and audit concepts into clear, practical, and engaging learning experiences
• Strong analytical skills to identify error patterns, knowledge gaps, and training opportunities based on audit data
• Effective communication and facilitation skills, with the ability to engage learners and manage group dynamics in a virtual environment
• Ability to collaborate cross-functionally with Quality, Audit, and SME partners
• Strong organizational and time management skills to manage multiple priorities and deadlines
• Proficiency with training and collaboration tools (e.g., LMS, MS Teams, Excel, PowerPoint)