Sr Manager– Data Mining & Exploratory Intelligence
HyderabadFull-time10–18 yrsPosted over a month ago
Leadership finance role at EXL in Hyderabad. Needs 10+ years.
About the role
The ideal candidate brings extensive hands-on claims experience and can “reverse engineer” claims behavior to inform data-driven strategies, tools, and controls. Extensive experience across Medicare, Medicaid or commercial business Demonstrated expertise in 360-degree claims review, auditing, and payment integrity
What you'll do
- Lead exploratory analysis of claims paid data to identify utilization patterns, anomalies, and potential overpaid or inappropriate claims
- Perform reverse engineering of claims outcomes to understand root causes of payment issues and system behaviors
- Translate operational and claims insights into clear use cases, concepts, and solution ideas for analytics and product teams
- Partner closely with analytics, product, and strategy teams to ensure solutions align with real-world claims operations
- Support ongoing refinement and scaling of claims monitoring and overpayment detection capabilities
What you need
- Claims processing
- Audit
- Product strategy
- Compliance