4536089-Manager

Claims Data Mining/Programmer - JD Job Description: Collect, clean and process large volumes of claims data using advance data mining tools. Perform data mining and identify trends, patterns and correlations within the claims data. Identify discrepancies and inconsistencies in claim payments by analyzing data in comparison to the historical claims data. Design and implement automated data extraction and reporting processes. Develop Python/VBA macros and applications to automate reporting. Reporting and presenting findings in a clear and actionable manner. Skills/Experience: Good experience with data mining and data analysis. Proficiency in data analysis tools such as Python, SQL, VBA. Knowledge of health insurance and claim processes is highly preferred. Strong analytical and problem-solving skills with keen attention to detail. Should understand VBA object model for Excel and Access very well. Experience in designing user form-based applications in MS Access and MS Excel. Should have good logical skills and should be able to translate a manual process flow to a Python/VBA code. Identifying overpayment opportunities by: Reviewing claims processing policies and guidelines. Reviewing provider contracts. Analyzing historical overpayment trends. Analyzing claims data to identify outliers. Contribute toward team's yearly target of overpayment identification. Review and validate claims. Assist team members and as and when required. Maintain and track overpayment projects in an organized and timely manner. Adhere to all client and company policies without exceptions. Candidate Profile: Education/Qualification: Any graduate/post-graduate Work Experience: 2 years+ as Python, SQL and VBA Programmer. Functional Skills: Python, SQL, VBA, MS Access and MS Excel. Behavioral/ Leadership Skills: Good English communication, very good logical skills, should be able perform as an individual contributor without much supervision. Should be able to understand and follow instructions, ask questions and make suggestions for processing improvement when required.EXL is the indispensable partner for leading businesses in data-led industries such as insurance, banking and financial services, healthcare, retail and logistics. We bring a unique combination of data, advanced analytics, digital technology and industry expertise to help our clients turn data into insights, streamline operations, improve customer experience, and transform their business. Our partnerships with clients are built on a foundation of collaboration - and we've been chosen as a partner by nine of the top ten leading US insurance companies, nine of the top 20 global banks, and six of the top ten US health care payers. We function as one team to make your goals our goals, whether that's unlocking the value of generative AI or embedding analytics into workflows that reduce risk or power your growth. Clients choose EXL as their transformation partner for many reasons. Our geographic diversity make talent all over the world instantly accessible. Digital accelerators enable unmatched speed-to-value, letting you realize results fast. It's our people that truly set us apart, though, including the 1,500 data scientists we have dedicated to our generative AI practice. And our more than twenty years of experience in delivering business services, garnering stellar client references, and maintaining a solid balance sheet are reassuring to our C-suite clients. Find out for yourself why clients, employees, and analysts think we're some of the best in the business. Contact us to see how we can help you achieve your goals.