Senior Executive

Job Description

Job Description_Contingency _Data Mining

Job Name:

Senior Executive - Datamining

Position Title:

Senior Executive

Band:

A2

ERP Full Position ID:

Reporting to:

Assistant Manager

Location/Site:

EXL India

Overview

Candidates should have minimum 3+ years of experience and must have knowledge in claims adjudication process and its processing methods.

Qualifications:

1. Graduation is Mandatory
2. Claims adjudication experience is Mandatory
3. Prefer candidates with experience in Post adjudication/overpayment projects (Not mandatory)

Experience:

1. Claims Adjudication experience: Minimum 3 years
2. Overpayment experience (Optional)

Communication:

1. Strong written (documentation) and oral communication skills

Working Hours:

1. 40 hours per week as Full time employee
2. Shift time: 08:00 AM TO 05:00 PM IST (It might be changed based on project requirements)
3. Weekends : Off

Telecommuter/Internet requirements, if applicable:

1. High Speed internet connection at home, must be broadband
2. Must understand and adhere with telecommuter policy

Skills and abilities:

• 3+ years of experience in claims processing or claims adjudication.
• Should have a strong US healthcare knowledge.
• Should know the payment determination. Which means candidates should calculate the allowable without system support.
• Should identify the gaps for realizing higher revenue for data mining program.
• Should have a good communication with neutral accent preferred.
• Ensure assigned inventory should be completed with quality within TAT.
• Production, quality and other reports should update on timely manner as required.
• Must ensure availability for meeting/calls as required.
• Should be able to work independently with minimal guidance.
• Ensure candidates should follow compliance protocols without fail.