The posting
Job Description
In this role you will collaborate with Payment Integrity Audit program leaders, key client stakeholders, and cross-functional teams to enhance business requirements, perform inventory management and claim prioritization. The Payment Integrity Business Analyst will work closely with reporting and support teams to develop internal reporting and audit workflows.
The is an excellent opportunity for someone who is proactive, quality focused and has a diverse background in payment integrity audits, project and inventory management. The ideal candidate will be able to manage multiple follow-up items, communicate clearly with managers and team members, and track issues and escalate when additional support is needed. You will thrive in an environment that values innovation, teamwork, and excellence, and you’ll be empowered to contribute your expertise in a culture built on collaboration, inclusiveness, and ongoing support.
*Base Pay Range: $75,100 - $123,400
For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits
Responsibilities
- Collaborate across all current and future client PI Audit programs to define and document client business requirements.
- Monitor audit inventory for aging, prioritization, and forecasting
- Partner with managers, reporting and support teams, and other internal partners to help resolve issues in a timely manner.
- Partner with reporting teams to provide report logic to ensure accurate inventory and MBR reporting
- Support operational projects to drive process improvement
- Maintain Provider audit letter templates and client requested approvals and updates
- Address provider issues received regarding medical records/audit requests
- Identify and assist with implementing process enhancements
- Access client’s claim systems to validate claims and claim reimbursement terms
- Maintain provider manager address application
Qualifications
- 5 years of experience in Payment Integrity Audit & Recovery Programs
- Strong analytical skills, with attention to details and ability to problem solve
- Attention to detail and ability to problem solve
- Project Management experience
- Data driven problem solving
- Advanced skills in Microsoft Excel, Word, Teams and other standard business tools
- Excellent oral and written communication skills
- Ability to multiple tasks in a fast-paced environment with attention to detail.
- Capable of building and maintaining strong interdepartmental working relationships
- Reliable, responsive, and accountable, with a strong sense of ownership for assigned follow-up tasks.
Education and Required Certification:
- Bachelor’s degree preferred or equivalent work experience in payment integrity services
EXL Offers:
- EXL Health offers an exciting, fast-paced, and innovative environment that brings together a group of sharp and entrepreneurial professionals who are eager to influence business decisions.
- From the very first day, employees have the opportunity to work closely with experienced healthcare, quality, and audit professionals.
- You can expect to learn many aspects of the healthcare Payment Integrity business while building effective teamwork, communication, organization, and time-management skills.
- This role provides valuable exposure to healthcare audit operations, onboarding coordination, manager support, and the systems and processes that help teams operate efficiently.
- The unique experiences gained at EXL Health set the stage for further growth and development.
*The posted base salary range is the hiring base salary range for this role. Final offers are based on several factors, including: the candidate's skills and experience, internal pay equity, work location, market conditions for the role, and the specific scope and responsibilities of the position.
About Us
EXL (NASDAQ: EXLS) is a leading data analytics and digital operations and solutions company. We partner with clients using a data and AI-led approach to reinvent business models, drive better business outcomes and unlock growth with speed. EXL harnesses the power of data, analytics, AI, and deep industry knowledge to transform operations for the world’s leading corporations in industries including insurance, healthcare, banking and financial services, media and retail, among others. EXL was founded in 1999 with the core values of innovation, collaboration, excellence, integrity and respect. We are headquartered in New York and have more than 54,000 employees spanning six continents. For more information, visit www.exlservice.com.
EXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates. EXL will only extend a job offer after a candidate has gone through a formal interview process with members of EXL’s Human Resources team, as well as our hiring managers.
EXL is the indispensable partner for leading businesses in data-led industries such as insurance, banking and financial services, healthcare, retail and logistics. We bring a unique combination of data, advanced analytics, digital technology and industry expertise to help our clients turn data into insights, streamline operations, improve customer experience, and transform their business. Our partnerships with clients are built on a foundation of collaboration – and we’ve been chosen as a partner by nine of the top ten leading US insurance companies, nine of the top 20 global banks, and six of the top ten US health care payers. We function as one team to make your goals our goals, whether that’s unlocking the value of generative AI or embedding analytics into workflows that reduce risk or power your growth. Clients choose EXL as their transformation partner for many reasons. Our geographic diversity make talent all over the world instantly accessible. Digital accelerators enable unmatched speed-to-value, letting you realize results fast. It’s our people that truly set us apart, though, including the 1,500 data scientists we have dedicated to our generative AI practice. And our more than twenty years of experience in delivering business services, garnering stellar client references, and maintaining a solid balance sheet are reassuring to our C-suite clients. Find out for yourself why clients, employees, and analysts think we’re some of the best in the business. Contact us to see how we can help you achieve your goals.



