EXL Looking for a Lead Assistant manager with a minimum of 9+ years of experience and must have in-depth knowledge of claims adjudication process and its processing methods. Data mining experience will be an added advantage.

Skills and abilities:

- Should have a valuable understanding of the US healthcare system and management.
- Should have thorough understanding of healthcare payer analytics specifically the business model for datamining operations.
- Preferably candidates should have work experience in the data mining Medicare or Commercial line of business.
- Should have thorough understanding of the payer system loopholes in the claims cost management.
- Should be able to think beyond horizon as ways to clog in those gaps for realizing higher revenue for datamining program.
- Will be responsible for auditing claims on Medicare or Commercial business based various data mining concepts to find overpayments.
- Will be responsible for bringing in new idea to refine concept to remove false positive




- The position is purely metrics and target driven in the perspective of claim audits to initiate overpayment that exist in deployed data mining concepts.
- The position will be strictly evaluated based on the accuracy over claim audits and overpayments identification
- Should possess a strong interpersonal skill set to be able to work well with other people/teams, including in teams or groups, formally and informally.
- Should be able to work independently with minimal guidance.
- Should be purely data and metrics driven person and discuss with Manager on a regular basis on the program/individual.

Must have:

- Claims Adjudication experience: Minimum 9 years
- Overpayment experience.
- Prefer candidates with experience in Post adjudication/overpayment projects.

Qualification:

Any Graduation

📌 Assistant Manager (India)
🏢 EXL
📍 India