Trainer / Quality Analyst – Data Mining, Payment Integrity

Ex; United States; A distancia; USD 75.000 - 90.000; Jornada completa

Descripción de la vacante

Ex is seeking a detail-oriented auditor to review completed audit findings, validate overpayment opportunities, and ensure alignment with client requirements, coding guidelines, pricing rules, and claim payment methodologies.

The ideal candidate brings healthcare claims knowledge, strong analytical thinking, and the ability to deliver virtual training and clear feedback to improve auditor performance, recovery outcomes, and continuous improvement.

Formación

• Knowledge of healthcare claims processes and guidelines.
• Experience applying coding guidelines, pricing rules, and claim payment methodologies.
• Ability to design training plans and learning resources.

Responsabilidades

• Review audit findings and validate overpayment opportunities.
• Ensure repricing accuracy and supporting documentation.
• Provide coaching and virtual training to auditors.

Conocimientos

Healthcare claims

Analytical thinking

Attention to detail

Virtual training

Communication skills

Feedback coaching

Descripción del empleo

This position reviews completed audit findings, validates overpayment opportunities, confirms claim repricing accuracy and supporting documentation, develops and supports training plans and learning resources, and ensures audit work aligns with client requirements, coding guidelines, pricing rules, and claim payment methodologies. The ideal candidate brings strong healthcare claims knowledge, analytical thinking, attention to detail, virtual training capability, effective communication skills, and the ability to provide clear feedback, coaching, and training support that strengthens auditor performance, continuous improvement, and recovery outcomes.

Salary Range: $75,000 – $90,000 (based on experience, skills, and qualifications)
Location: 100% Remote (U.S.-based)
Up to 10% annual travel (for team meetings and limited client onsite engagements.)

For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits