4536089-Manager

EXL; Dadri; On-site; INR 600,000 - 1,000,000; Full time

Job summary

EXL in India seeks a Claims Data Mining/Programmer to collect, clean and process large volumes of claims data, and to automate reporting using Python and VBA. You will mine data to identify trends and discrepancies in claim payments, designing automated extraction and reporting workflows.

Strong analytical skills, Excel/Access form development, and the ability to translate manual processes into code are essential.

Qualifications

• Experience in data mining and data analysis.
• Proficiency with Python, SQL and VBA.
• Knowledge of health insurance and claim processes is highly preferred.
• Strong analytical and problem-solving skills with attention to detail.
• Good understanding of VBA object model for Excel and Access.
• Experience designing user form-based apps in MS Access and MS Excel.
• Ability to translate manual process flows into Python/VBA code.

Responsibilities

• Collect, clean and process large volumes of claims data.
• Perform data mining to identify trends, patterns and correlations.
• Identify discrepancies by comparing current vs historical claims data.
• Design and implement automated data extraction and reporting.
• Develop Python/VBA macros to automate reporting.
• Report and present findings clearly and actionable.
• Review and validate claims, assist teammates as required.
• Maintain and track overpayment projects in an organized manner.

Skills

Data mining

Data analysis

Python

SQL

VBA

MS Access

MS Excel

Logical skills

Problem-solving

Translating process to code

Education

Any graduate/post-graduate

Tools

Python

SQL

VBA

MS Access

MS Excel

Job description

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.