Sr Manager– Data Mining & Exploratory Intelligence

ExlService Holdings, Inc.; Hyderabad; On-site; INR 1,200,000 - 1,700,000; Full time

Job summary

EXL Talent Acquisition Team in Hyderabad seeks a data analytics professional focused on identifying claims patterns, anomalies, and potential overpayments across Medicare, Medicaid and commercial business. The ideal candidate brings extensive hands-on claims experience and can reverse engineer claims behavior to inform data-driven strategies, tools, and controls.

You will collaborate with analytics, product, strategy and compliance teams to translate insights into actionable analytics concepts

Qualifications

• Experience with claims review, auditing, and payment integrity.
• Ability to identify patterns and anomalies in large datasets.
• Experience communicating complex claims concepts clearly.
• Experience bridging operations and data science.
• Experience collaborating with analytics, product, strategy, or compliance teams.

Responsibilities

• Identify claims patterns, anomalies, and potential overpayments across Medicare/Medicaid and commercial lines.
• Translate operational insights into analytics concepts and solutions.
• Collaborate with cross-functional teams to drive payment integrity initiatives.

Skills

Claims analytics

Data mining

Payment integrity

Medicare/Medicaid experience

Cross-functional collaboration

Communication

Job description

This role will focus on identifying claims patterns, anomalies, and potential overpayments across Medicare, Medicaid and commercial business, while translating deep operational insight into actionable analytics concepts and solutions.

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
• 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