Senior Executive EXL Specialist

1 week ago


Chennai, Tamil Nadu, India exl Full time

Job Role: Senior Executive EXL/SE

At EXL, we seek a Claims Adjudication Manager with expertise in US Healthcare Payer/Provider LOB.

Key Responsibilities:

  1. Specifically in Claims adjudication, claims processing, pricing, administrative records review
  2. Medical Records Management, Clinical Audit based on Medical Records Review
  3. Seasoned experience in US Healthcare (Payer/Provider LOB)

Requirements:

  1. Preferred to have worked over a period of time in US Healthcare payer/provider domain
  2. Understand the business model for our delivery center and then implement the same in the training vertical
  3. Should have effective communication skills to coordinate with program SMEs and candidates
  4. Should be well-acquainted with reporting, presentations, creating training materials (videos/document) in granular level
  5. Should possess understanding of High Cost Drug and Durable Medical equipment auditing through Medical records review

Preferred Qualifications:

  1. Previously working for US Healthcare Payer vertical/LOB will be an added advantage


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