Payment Integrity SME — Part-Time Audit Innovator

EXL Talent Acquisition Team; United States; On-site; USD 103,000 - 138,000; Part time

Job summary

EXL Service seeks experienced Inpatient and Outpatient Payment Integrity SMEs to identify overpayment opportunities, develop new audit concepts, and enhance analytics. This part-time, temporary role requires up to 20 hours per week and is project-based for 4–6 months, with a base pay range of $75.00–$100.00/hr.

The SME will collaborate with analytics, clinical, coding, operations, and technology teams to translate billing expertise into scalable audit concepts, rules, and automated selection

Qualifications

• Deep knowledge of healthcare claims, coding, reimbursement, audit outcomes, and billing patterns across inpatient and outpatient settings.

Responsibilities

• Collaborate with analytics, clinical, coding, operations, and technology teams to translate healthcare billing expertise into scalable audit concepts, business rules, and automated selection strategies.
• Develop and refine audit concepts, concepts and rules to identify overpayments and improve payment integrity analytics.
• Translate claim-level insights into actionable audit concepts and selection strategies for faster, more accurate results.

Skills

Healthcare claims

Billing patterns

Audit concepts

Cross-functional collaboration

Job description

EXL Service seeks experienced Inpatient and Outpatient Payment Integrity SMEs to identify overpayment opportunities, develop new audit concepts, and enhance analytics. This part-time, temporary role requires up to 20 hours per week and is project-based for 4–6 months, with a base pay range of $75.00–$100.00/hr.

The SME will collaborate with analytics, clinical, coding, operations, and technology teams to translate billing expertise into scalable audit concepts, rules, and automated selection