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Hiring companyEXL
Verified today
Senior Executive - Claims Audit
Chennai, Tamil Nadu, India Full-time Hybrid
About the role
Review and analyze medical records and claims to ensure accuracy, completeness, and compliance with healthcare regulations and payer requirements. Verify clinical documentation, resolve inconsistencies, prioritize workloads, collaborate with providers, coders, and billing staff, maintain HIPAA compliance, prepare reports, support audits, and improve processes.
What you’ll do
- Complete training and meet expectations
- Follow SOPs diligently
- Conduct audits promptly and ensure quality
- Meet quality and production targets
- Adhere to project protocols
- Report issues or trends promptly
- Update logs (productivity, clarification)
- Seek clarification from manager or team leader
- Respond promptly to manager emails
- Ensure compliance with regulations and policies
What you’ll bring
- Graduate/Postgraduate degree
- 3-5 years experience in claims audit
- Strong analytical and investigative skills
- Proficient in Microsoft Office (Outlook, Excel, Word, PPT)
- Knowledge of HIPAA, Medicare, Medicaid regulations
Skills
Analytical AbilityClaim VerificationCommunication SkillsMicrosoft OfficeHIPAA Knowledge
Education
Bachelor's Degree