Description

Communication Skill:

Solid written (documentation) and oral communication skills

Working Hours:

Full time role (40 hours/week).

Shift: 08:00 AM – 05:00 PM IST (subject to change based on project requirements).

Weekends: Off (may vary based on business needs).

Telecommuter/Internet requirements, if applicable:

High Speed internet connection at home must be broadband.

Must understand and adhere with telecommuter policy.

Responsibilities

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 line of business.
Should have thorough understanding contract audits, duplicates, reimbursement policies
Will be responsible to audit claims on Medicare or Commercial business based various data mining concept.




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.

Qualifications

Experience:

Claims Adjudication experience: Minimum 6 years

Overpayment experience.

Prefer candidates with experience in Post adjudication/overpayment projects.

Qualification:

Graduation is mandatory.

📌 Assistant Manager Datamining Telangana
🏢 EXL
📍 Telangana