Lead Assistant Manager - Datamining

EXL Service -
Hyderabad, Telangana

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Job details

Full-time
17 hours ago

Qualifications

Data mining
Analytics

Full job description

Job Description: 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 good 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.

Qualifications: Experience:

Claims Adjudication experience: Minimum 9 years
Overpayment experience.

Prefer candidates with experience in Post adjudication/overpayment projects.

Qualification:

Graduation is mandatory.

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