Lead Assistant Manager
ChennaiFull-time7–13 yrsPosted 4 months ago
Senior data science role at EXL in Chennai. Needs 7+ years.
About the role
We are seeking an experienced Clinical Coding Subject Matter Expert (SME) to support the development, validation, and continuous improvement of AI-powered solutions across its Healthcare Payer Practice. In this role, you will work closely with AI engineers, product managers, and client-facing teams to ensure that our solutions reflect real-world coding standards, payer policies, and clinical accuracy.
What you'll do
- Work closely with AI engineers, product managers, and client-facing teams to ensure that our solutions reflect real-world coding standards, payer policies
- Serve as the primary clinical coding advisor for AI product teams, providing guidance on ICD-10-CM/PCS, CPT/E&M, and DRG/inpatient coding rules, conventions
- Partner with Legal and Compliance teams to ensure coding logic adheres to applicable federal and state regulations, including HIPAA and CMS standards
- Collaborate with AI engineers and data scientists to define coding logic, decision trees, and clinical criteria used in AI model development and prompt engineering
- Translate complex clinical coding rules into structured, machine-readable formats (e.g., YAML, JSON decision trees) for consumption by AI pipelines
What you need
- Machine learning
- SQL
- Python
- NLP
- Medical coding
- Claims processing
Good to have
- Data structures
- Data visualisation
- Power BI
- Tableau
- Prompt engineering
- Test cases