Job Description_Contingency _Data Mining

Job Name:

Executive - Datamining

Position Title:

Executive

Band:

A1

Reporting to:

Assistant Manager

Location/Site:

EXL India

Overview

Candidates should have minimum 1+ years of experience and should have basic 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 1 year
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:

• 1+ years of experience in claims processing or claims adjudication.
• Should have knowledge in US healthcare.
• Preferably candidates have knowledge in payment determination. Which means candidates should calculate the allowable without system support (Not mandatory).
• Prefer candidates with experience in overpayment projects.
• 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.
• Ability to work independently and as a team.
• Ensure candidates should follow compliance protocols without fail.