Exl Service

  • Auditor I - Data Mining

    Job Location US-REMOTE | US
    SCIO Healthcare Analytics
    Regular Full-Time
  • Overview

    EXL/SCIO Health Analytics is seeking an experienced and self-motivated Auditor I – Data Mining with medical claims experience. This is a Home Office Opportunity.
    The Auditor I – Data Mining is responsible for reviewing the output of queries to identify overpayments. Must be able to follow instructions provided on how to validate overpayments for each query.


    Key Duties and Responsibilities:
    • Review output of queries for overpayments.
    • Follow Query Step-by-Step Documentation to validate overpayments.
    • If available, utilize claims system(s) to verify overpayments.
    • Document overpayments/not overpayments in production systems. Claims not overpaid should have clear reason for research purposes.
    • Meet quality and production standards:
    • Record production tasks and time into format outlined by Management.
    • Communicate to Management any issue(s) that would impede completion of assigned work.
    • Work with Management to ensure these issues are resolved.
    • Provide feedback to Management on areas of improvement.


    Knowledge and Skills:
    • Attention to Detail
    • Excellent written and oral communication skills
    • Flexible during times of change - Adjust to shifting priorities and timelines through analytical and problem solving capabilities
    • Must be able to learn, understand, and apply new technologies
    • High School Diploma or Equivalent Required
    • College Degree or Equivalent Work Experience
    • 1-2 Years’ Experience Auditor
    • 1-2 Years’ Experience with Medical Claims Processing

    EEO Statement



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