Job Description

Senior ExecutiveEXL/SE/1385014


Payment ServicesChennai
Posted On
19 Jun 2025
End Date
03 Aug 2025
Required Experience
3 - 5 Years



Basic Section
Number Of Positions


1


Band


A2


Band Name


Senior Executive


Cost Code


D004863


Campus/Non Campus


NON CAMPUS


Employment Type


Permanent


Requisition Type


Backfill


Max CTC


400000.0000 - 1000000.0000


Complexity Level


Not Applicable


Work Type


Hybrid - Working Partly From Home And Partly From Office


Organisational
Group


Healthcare


Sub Group


Healthcare


Organization


Payment Services


LOB


Payment Services


SBU


Payment Integrity - Operations


Country


India


City


Chennai


Center


IN Chennai C51




Skills
Skill


MS WORD


EXCEL


POWERPOINT


CLINICAL


DOCUMENTATION


Minimum Qualification


BACHELOR OF SCIENCE (B.SC) - NURSING


Certification


No data available



_Contingency _Home Health India RN

Job Name:

Senior Executive

Position Title:

Senior Executive - Clinical Auditor

Band:

A2

ERP Full Position ID:

Reporting to:

Assistant Manager

Location/Site:

EXL India

Overview

Registered Nurse with minimum 3 years of clinical experience and skillset, responsible for reviewing/auditing claims with medical record and identify the findings based on the billing. Performs best practice reviews and identify areas for improvement. Check on compliance with CMS guidelines

Qualifications:

Bachelor's degree in nursing Active State Nursing certification is Mandatory Minimum 3 years of clinical/hospital experience is mandatory

Communication:

Strong written (documentation) and oral communication skills

Experience:

Minimum 3 years of clinical experience. Auditing experience (Optional)

Working Hours:

40 hours per week as Full-time employee Shift time: 08:00 AM TO 05:00 PM IST (It might be changed based on project requirements) Weekends: Off

Telecommuter/Internet requirements, if applicable:

High Speed internet connection at home, must be broadband Must understand and adhere with telecommuter policy

Skills and abilities:

Familiarity with basic medical terminology and concepts used in care management. Ability to effectively participate in a multi-disciplinary team including internal and external participants. Should have a good understanding of US healthcare system and management. Perform audit based on clinical knowledge while reviewing the medical record Demonstrate learning skills during process training and in advancing career Perform quality assurance reviews to assess comprehension of training efforts. Ensure to process the audit with accountability Ensure to view all documented system information as well as any additional records/data presented to support a determination or recommendation. Condenses all clinical information into a clear and precise clinical picture while taking a final decision. Pro-actively and consistently engage in enhancing process/work knowledge and delivery the work with high values. Actively update process knowledge and follow the new change in process. Be ready to analyze the errors and if required approach to quality team for further clarification. Maintain a professional work environment. Follow every aspect of SOP without fail. Complete received Audits with Quality. Achieve expected Quality and production target. Follow project-related protocols and instructions. Update all the logs like productivity, Clarification log, and any other logs applicable daily. Complete alignment with Manager /TL in terms of program delivery. Responding to all emails promptly without fail. Ensure compliance of the entire team.

Workflow
Workflow Type


L&S-DA-Consulting