EXL

4100999-Senior Manager

EXL  •  Noida, IN (Onsite)  •  1 month ago
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Job Description

Job Description & 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).
EXL

About EXL

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.

Industry
Consulting & Advisory
Company Size
10,000+ employees
Headquarters
New York, NY
Year Founded
Unknown
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