Senior Executive – Claims Audit

EXL

Claims audit executive reviewing medical records and claims for EXL, a data analytics and digital operations company. Ensuring compliant, accurate, and timely healthcare claim processing.

Posted 9/4/2026full-timeChennai • 🇮🇳 IndiaSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in reviewing and analyzing medical records and claims data for accuracy and compliance, with a strong understanding of healthcare terminology and coding standards. Proficient in collaborating with healthcare providers and ensuring adherence to regulatory guidelines such as HIPAA and CMS.

Highest-signal resume keywords

Medical Record ReviewClaims Data AnalysisHIPAA ComplianceHealthcare TerminologyAnalytical Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ProcessingCoding Standards (ICD, CPT, HCPCS)Regulatory ComplianceData AnalysisReport Preparation

Soft Skills

Good CommunicationFlexibilityReliability

Tools & Technologies

Microsoft OutlookMicrosoft ExcelMicrosoft WordMicrosoft PowerPoint

Industry Keywords

MedicareMedicaidPayer-Specific RegulationsQuality AssuranceSOPs

About the role

Key responsibilities & impact

Review and analyze medical records and claims data for accuracy, completeness, and compliance
Verify clinical documentation supporting claim submissions and medical necessity
Identify and resolve inconsistencies, errors, and missing documentation
Prioritize workloads and process expedited and high-priority cases within timelines
Collaborate with healthcare providers, coders, and billing staff
Ensure compliance with HIPAA, CMS, and other regulatory guidelines
Prepare reports and summaries of claim findings, trends, and process improvements
Support internal audits and quality assurance initiatives
Complete audits promptly and meet quality and production targets
Follow SOPs, project protocols, and relevant regulations
Report issues or trends and maintain productivity and clarification logs
Seek clarification from managers or team leaders and respond to manager emails

Requirements

What you’ll need

Any Graduate/Postgraduate
3–5 years of experience
Good communication, flexibility, and reliability
Knowledge of Microsoft Outlook, Excel, Word, and PowerPoint
Strong analytical skills with the ability to investigate and resolve issues
Familiarity with HIPAA, Medicare, Medicaid, and other payer-specific regulations
Understanding of healthcare terminology, coding standards (ICD, CPT, HCPCS), and insurance claim procedures
40 hours per week
High-speed internet connection and power backup

Benefits

Comp & perks

Training from office for 2 months and hybrid thereafter
High-speed internet connection and power backup requirements for telecommuting
Full-time employment