Job Description

Senior ManagerEXL/SM/1433582


Payment ServicesChennai
Posted On
26 Jul 2025
End Date
09 Sep 2025
Required Experience
12 - 18 Years



Basic Section
Number Of Positions


1


Band


C2


Band Name


Senior Manager


Cost Code


D005930


Campus/Non Campus


NON CAMPUS


Employment Type


Permanent


Requisition Type


Backfill


Max CTC


1100000.0000 - 2200000.0000


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


MEDICAL CODING


AUDIT


SME


ANALYSIS


MANAGEMENT


Minimum Qualification


BACHELOR OF SCIENCE


Certification


No data available



& Skills Requirements

Job Name:

Manager

Position Title:

Senior Manager

Band:

C2

Role: Managment

Reporting to:

AVP / Sr. AVP

Location/Site:

EXL India

Overview:

Senior Manager is responsible for leading strategic initiatives that ensure accurate and appropriate healthcare payments. This includes leveraging advanced medical coding analysis, enforcing policy adherence, and driving overpayment recovery programs. The role plays a critical part in identifying automation and digitalization opportunities to streamline coding processes and enhance operational efficiency.

Qualifications:

Bachelor's Degree B.sc/M.Sc./Nursing/Pharmacy/Biotech

Certifications:

CPC/COC -

Certified Professional / Outpatient coder

CCS -

Certified Coding Specialist

CIC -

Certified Inpatient Coder

Experience:

Sr. Manager:

12 to 18 years' experience in medical coding, auditing and automation.

Skills and Abilities:

Advanced knowledge of medical coding software platforms (e.g., 3M Code Finder, Optum360, True Code, Epic, Cerner, etc.). Minimum 12 years of hands-on experience in multispecialty medical coding. Knowledge of automation tools is an added advantage. Payer experience is an added advantage. Expertise in Microsoft outlook/excel/word/Power BI. Analytical skills Team management Program management - TAT, escalations, Quality Strategic thinking / decision making Cost management - GM, GC, RPE

Primary Roles and Responsibilities:

Strategic leadership:

Client Market share analysis & strategy to hold more shares by conducting opportunity analysis & planning.Prepare and present reports on new finding opportunities financial impacts and existing High and low finding opportunities to leadership.

Digital:

Design and lead initiatives to optimize claims processing and identify fraud, waste and abuse. To identify and implement automation and digital transformation to enhance organizational growth. Leverage advanced analytics to identify overpayments. Explore and implement AI/ML solutions for fraud detection and claim validation.

Team management:

Lead team of SMEs, AMs and Managers, providing mentorship, performance reviews and training.

Cross-functional collaboration:

collaboration with clinical operations, coding operations, quality, repricing, training, digital, IT and technology to align with organizational growth. Interface with onshore and clients to resolve disputes and explain audit findings.

Data and Reporting:

Analyze large data sets to detect aberrant payment patterns and coding patterns / trends. Prepare and maintain SOPs & Audit manuals wherever necessary.

Additional Roles and Responsibilities:

Handle Think team which has subject matter experts Oversee Think operations of payment integrity. Manage staffing, scheduling, and resource allocation Stay updated on changes in healthcare. Develop and implement quality improvement initiatives. Strategic planning process to align organizational goals. Engage in market analysis to understand the competitive landscape. Maintaining SOP and Audit manual. Track key performance indicators (KPIs).

Workflow
Workflow Type


L&S-DA-Consulting