Description
Claims Data Mining/Programmer – JD Job Description: Ø Collect, clean and process large volumes of claims data using advance data mining tools. Ø Perform data mining and identify trends, patterns and correlations within the claims data. Ø Identify discrepancies and inconsistencies in claim payments by analyzing data in comparison to the historical claims data. Ø Design and implement automated data extraction and reporting processes. Ø Develop Python/VBA macros and applications to automate reporting. Ø Reporting and presenting findings in a clear and actionable manner. Skills/Experience: Ø Good experience with data mining and data analysis. Ø Proficiency in data analysis tools such as Python, SQL, VBA. Ø Knowledge of health insurance and claim processes is highly preferred. Ø Strong analytical and problem-solving skills with keen attention to detail. Ø Should understand VBA object model for Excel and Access very well. Ø Experience in designing user form-based applications in MS Access and MS Excel.



Ø Should have good logical skills and should be able to translate a manual process flow to a Python/VBA code. Ø Identifying overpayment opportunities by: Reviewing claims processing policies and guidelines. Reviewing provider contracts. Analyzing historical overpayment trends. Analyzing claims data to identify outliers. Ø Contribute toward team’s yearly target of overpayment identification. Ø Review and validate claims. Ø Assist team members and as and when required. Ø Maintain and track overpayment projects in an organized and timely manner. Ø Adhere to all client and company policies without exceptions. Candidate Profile: Education/Qualification: Any graduate/post-graduate Work Experience: 2 years+ as Python, SQL and VBA Programmer. Functional Skills: Python, SQL, VBA, MS Access and MS Excel. Behavioral/ Leadership Skills: Valuable English communication, very good logical skills, should be able perform as an individual contributor without much supervision. Should

📌 4536089-Manager (Noida)
🏢 EXL
📍 Noida