Assistant Manager
About the Role
Candidates should have a minimum of 6+ years of experience and must have in-depth knowledge of claims adjudication process and its processing methods. Data mining experience will be an added advantage.
Key Skills for This Role
Full Job Posting
Qualifications
- Bachelor�s degree in Data Science, Computer Science, Statistics, or a related field. 2-3 years of experience in data mining or data analysis.
- Experience:
- Claims Adjudication experience: Minimum 6 years Overpayment experience.
- Prefer candidates with experience in Post adjudication/overpayment projects.
- Qualification:
- Graduation is mandatory.
- Communication Skill:
- Strong written (documentation) and oral communication skills
- 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.
- Claims Adjudication experience: Minimum 6 years
- Overpayment experience.
- 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).
Responsibilities
- Lead Small-scale Data Mining Projects: Manage and oversee smaller data mining projects, ensuring they are completed efficiently and effectively. Align Data Models with Business Objectives: Ensure that data models are designed and implemented to meet the specific objectives and goals of the business. Mentor Junior Data Analysts: Provide guidance and support to junior data analysts, helping them develop their skills and knowledge. Improve Efficiency of Data Processing: Enhance the efficiency of data processing and model implementation to optimize performance and results. Adherence to Organizational Standards: Ensure that all data mining activities comply with the organization's standards and policies. Engage with Stakeholders: Communicate and collaborate with stakeholders to understand their needs and ensure that data mining efforts are aligned with their requirements.
- 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 line of business. • Should have thorough understanding contract audits, duplicates, reimbursement policies
- Will be responsible to audit claims on Medicare or Commercial business based various data mining concept. • 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
- Lead Small-scale Data Mining Projects: Manage and oversee smaller data mining projects, ensuring they are completed efficiently and effectively.
- Align Data Models with Business Objectives: Ensure that data models are designed and implemented to meet the specific objectives and goals of the business.
- Mentor Junior Data Analysts: Provide guidance and support to junior data analysts, helping them develop their skills and knowledge.
- Improve Efficiency of Data Processing: Enhance the efficiency of data processing and model implementation to optimize performance and results.
- Adherence to Organizational Standards: Ensure that all data mining activities comply with the organization's standards and policies.
- Engage with Stakeholders: Communicate and collaborate with stakeholders to understand their needs and ensure that data mining efforts are aligned with their requirements.
- 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 line of business.
- Should have thorough understanding contract audits, duplicates, reimbursement policies
- Will be responsible to audit claims on Medicare or Commercial business based various data mining concept.
- 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
About EXL
EXL is a global data and AI company that provides analytics, digital operations, and industry-specific services to enterprises in insurance, healthcare, banking, retail, media, and energy.
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