Senior Executive - Data Mining

Role Overview EXL is looking for a Senior Executive in Data Mining to join its India operations in Chennai. This role is ideal for professionals with hands-on experience in claims adjudication and US healthcare processes who can work independently while maintaining high quality and compliance standards. The position involves identifying revenue gaps and processing claim-related data accurately within defined turnaround times. Key Responsibilities - Review and process medical claims using knowledge of adjudication rules and payment determination methods - Calculate allowable amounts without relying on system support and ensure accuracy in all claim assessments - Identify revenue gaps and opportunities within the data mining program to support overpayment recovery - Complete assigned inventory within the required turnaround time while meeting quality benchmarks - Update production, quality, and operational reports in a timely manner as specified - Adhere to compliance protocols and telecommuter policies at all times - Attend meetings and calls as required and maintain consistent availability during shift hours Required Qualifications - Graduation is mandatory - Minimum 3 years of hands-on experience in claims adjudication or claims processing - Strong working knowledge of US healthcare systems and payment determination - Experience in post-adjudication or overpayment projects is preferred but not mandatory - Strong written and verbal communication skills with a neutral accent preferred - High-speed broadband internet connection available at home - Ability to work independently with minimal supervision Why Join Us EXL is a globally recognised analytics and operations management company offering meaningful work in the US healthcare domain with a structured shift and weekends off. This is a strong opportunity to deepen your expertise in claims and data mining while growing within a reputed organisation.

- Minimum 3 years of experience in claims adjudication or claims processing - Strong knowledge of US healthcare and payment determination - Ability to calculate allowable amounts without system support - Experience identifying revenue gaps for data mining programs - Strong written and oral communication skills - Ability to work independently with minimal guidance - High-speed broadband internet connection at home - Graduation mandatory - Experience in post-adjudication or overpayment projects preferred

- Fixed day shift with weekends off - Work from home eligible with telecommuter policy - Full-time employment with structured 40-hour work week