Job Description

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.

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Skills and abilities:

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




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- The position is purely metrics and target driven in the perspective of claim audits to initiate overpayment that exist in deployed data mining concepts.
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- The position will be strictly evaluated based on the accuracy over claim audits and overpayments identification
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- 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.
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- Should be able to work independently with minimal guidance.
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- Should be purely data and metrics driven person and discuss with Manager on a regular basis on the program/individual.
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Must have:

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

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Any Graduation

📌 Assistant Manager (Hyderabad)
🏢 EXL
📍 Hyderabad