- EXL
- United States,
- Full-Time
- 48 days ago
- $75,000 – $90,000
Quality Analyst – Data Mining, Payment Integrity.
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Quality Analyst – Data Mining, Payment Integrity: our view in 3 lines...
- The Role:This role is for someone who reviews healthcare claim audit work in a data mining and payment integrity program.
- The Person:The person will review completed audit findings, validate overpayment opportunities, confirm claim repricing accuracy and supporting documentation, and check audit work against client requirements and payment rules.
- Requirements:The ideal candidate brings strong healthcare claims knowledge, analytical thinking, and attention to detail, with experience in coding guidelines, pricing rules, and claim payment methodologies.
About the role
The Quality Analyst – Data Mining, Payment Integrity plays a key role in ensuring the accuracy, quality, and consistency of audit work performed within the Data Mining program. This position is responsible for reviewing completed audit findings, validating overpayment opportunities, confirming claim repricing accuracy and supporting documentation, and ensuring 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, and the ability to provide clear feedback that supports auditor performance, continuous improvement, and stronger 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
