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: Graduation is Mandatory Claims adjudication experience is Mandatory Prefer candidates with experience in Post adjudication/overpayment projects (Not mandatory) Experience: Claims Adjudication experience: Minimum 3 years Overpayment experience (Optional) Communication: Strong written (documentation) and oral communication skills Working Hours: 40 hours per week as Full time employee Shift time: 08:00 AM TO 05:00 PM IST (It might be changed based on project requirements) Weekends : Off Telecommuter/Internet requirements, if applicable: High Speed internet connection at home, must be broadband 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.
