Healthcare Claims Auditing Specialist

13 hours ago


Delhi, Delhi, India EXL Full time

At EXL, we are seeking a highly skilled and experienced Healthcare Claims Auditing Specialist to join our team.

As a Healthcare Claims Auditor, you will play a critical role in ensuring the accuracy and integrity of healthcare claims. Your expertise will be utilized to review and analyze medical records, identify discrepancies, and implement corrective actions to ensure compliance with regulatory requirements.

We are looking for an individual with a strong background in healthcare claims auditing, particularly in the US Healthcare Payer domain. Your experience should include claims adjudication, claims processing, pricing, administrative records review, and medical records management. Additionally, your skills in clinical audit, reporting, presentations, and creating training materials will be valuable assets to our team.

The ideal candidate will have a bachelor's degree and a minimum of 3 years of experience in healthcare claims auditing. You should possess excellent communication and analytical skills, with the ability to work effectively in a team environment. Your knowledge of business models, project protocols, and quality control processes is essential for success in this role.

Key Responsibilities:

  • Review and analyze medical records to identify discrepancies and areas for improvement.
  • Implement corrective actions to ensure compliance with regulatory requirements.
  • Develop and maintain effective communication with program SMEs and candidates.
  • Create high-quality reports, presentations, and training materials.
  • Collaborate with cross-functional teams to achieve quality and production targets.

Benefits and Perks:

At EXL, we offer a competitive salary range of $80,000 - $110,000 per year, depending on experience. Our comprehensive benefits package includes health insurance, retirement savings plan, paid time off, and professional development opportunities. We value diversity, equity, and inclusion and strive to create a workplace that is welcoming and inclusive for all employees.

This is an exciting opportunity to join a dynamic team and contribute to the growth and success of our organization. If you are a motivated and results-driven individual with a passion for healthcare claims auditing, please submit your application today



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