Manager– Data Mining & Exploratory Intelligence

ExlService Holdings, Inc.; Hyderabad; Hybrid; INR 900,000 - 1,500,000; Full time

Job summary

EXL Talent Acquisition Team is seeking a data analytics professional with extensive Medicare/Medicaid or commercial claims experience. The role focuses on 360-degree claims review, auditing, and enhancing payment integrity across large datasets.

The candidate should identify patterns and anomalies, bridge operations and data science, and collaborate with cross-functional teams to drive effective analytics and governance.

Qualifications

• Experience with Medicare/Medicaid or commercial claims.
• Strong analytical mindset and problem solving.
• Ability to explain complex claims concepts clearly.
• Experience collaborating with analytics, product, strategy, compliance.

Responsibilities

• Review 360-degree claims across programs (Medicare/Medicaid/commercial).
• Identify patterns, anomalies, and inappropriate payments in large datasets.
• Collaborate with analytics, product, strategy and compliance teams to drive payment integrity.
• Support claims analytics or data mining initiatives as needed.

Skills

Claims analytics

Data mining

Auditing

Pattern identification

Cross-functional collaboration

Communication skills

Operations to data science bridge

Job description

Extensive experience across Medicare, Medicaid or commercial business

• Demonstrated expertise in 360-degree claims review, auditing, and payment integrity
• Proven ability to identify patterns, anomalies, and inappropriate payments within large claims datasets
• Strong analytical mindset with the ability to bridge operations and data science
• Experience collaborating with cross-functional teams (analytics, product, strategy, compliance)
• Excellent communication skills with the ability to explain complex claims concepts clearly
• Prior involvement in payment integrity data mining or recovery initiatives
• Experience supporting or designing claims analytics or data mining non-clinical programs