Payment Integrity Concept Development SME

EXL · United States

The Subject Matter Expert (SME) – Payment Integrity Concept Development is responsible for designing, developing, and validating innovative payment integrity concepts that identify inaccurate, inappropriate, or unsupported healthcare claims. This individual combines deep expertise in medical coding, reimbursement methodologies, clinical documentation, regulatory guidance, and claims analytics to develop high-value overpayment detection opportunities that generate measurable savings.

The ideal candidate has a proven history of successfully developing new payment integrity concepts from initial idea through implementation, resulting in significant financial recoveries while maintaining high clinical accuracy and low provider abrasion.

*Base Pay Range: $75,100 - $107,300/yr

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

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 seeking a Subject Matter Expert within Payment Integrity Concept Development to join our team.

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