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Auditor II - Data Mining

Role overview

Qualifications

  • Knowledge of medical claims
  • Ability to exercise independent decision making
  • Familiarity with internal policies and procedures
  • Understanding of regulations and contractual agreements

Responsibilities

  • Review output of queries to identify potential overpayments
  • Perform audits following internal policies and procedures
  • Determine discrepancies and document findings
  • Use professional judgment in auditing processes

Key facts

Hard skills

Other skills

  • Decision Making
  • Professional Responsibility

About the company

EXL logo

EXL

  • Outsourcing & BPO
  • XLarge
  • 10,001+
Choosing a digital partner is about more than capabilities — it’s about collaboration and character. Unrealistic overhauls and off-the-shelf products ignore what matters most — your unique needs, culture, goals, and your legacy data and technology environments. At EXL, our collaboration is built on ongoing listening and learning to adapt our methodologies. We’re your business evolution partner—tailoring solutions that make the most of data to make better business decisions and drive more intelligence into your increasingly digital operations. Whether your goals are scaling the use of AI and digital, redesign operating models, or driving better and faster decisions, we’re here to partner with you to help you gain—and maintain—competitive advantage with efficient, sustainable models at scale. Our expertise in transformation, data science, and change management helps make your business more efficient and effective, improve customer relationships and enhance revenue growth. Instead of focusing on multi-year, resource- and time-intensive platform designs or migrations, we look deeper at your entire value chain to integrate strategies with impact. We use our specialization in analytics, digital interventions, and operations management—alongside deep industry expertise — to deliver solutions that help you outperform the competition. At EXL, it’s all about outcomes—your outcomes—and delivering success on your terms. Share your goals with us and together, we’ll optimize how you leverage data to drive your business forward. For more information, visit www.exlservice.com.

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Job description

The Auditor II – DM (Data Mining) reviews the output of queries to identify potential overpayments and performs the audit following set internal policies and procedures in accordance with the regulations and set contractual agreements between insurers and providers. Exercises independent decision making and professional judgment, using medical claims knowledge on a regular basis. The Auditor I determines if a discrepancy exists and documents the findings using standard documentation guidelines as applicable. 

*Base Pay Range: $18.50 - $30.00/hr

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

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