Payment Integrity Business Analyst

In this role you will collaborate with Payment Integrity Audit program leaders, key client stakeholders, and cross-functional teams to enhance business requirements, perform inventory management and claim prioritization.  The Payment Integrity Business Analyst will work closely with reporting and support teams to develop internal reporting and audit workflows.

The is an excellent opportunity for someone who is proactive, quality focused and has a diverse background in payment integrity audits, project and inventory management. The ideal candidate will be able to manage multiple follow-up items, communicate clearly with managers and team members, and track issues and escalate when additional support is needed. You will thrive in an environment that values innovation, teamwork, and excellence, and you’ll be empowered to contribute your expertise in a culture built on collaboration, inclusiveness, and ongoing support.

*Base Pay Range: $75,100 - $123,400
For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits

Responsibilities
- Collaborate across all current and future client PI Audit programs to define and document client business requirements.

- Monitor audit inventory for aging, prioritization, and forecasting

- Partner with managers, reporting and support teams, and other internal partners to help resolve issues in a timely manner.

- Partner with reporting teams to provide report logic to ensure accurate inventory and MBR reporting

- Support operational projects to drive process improvement

- Maintain Provider audit letter templates and client requested approvals and updates

- Address provider issues received regarding medical records/audit requests

- Identify and assist with implementing process enhancements

- Access client’s claim systems to validate claims and claim reimbursement terms

- Maintain provider manager address application

Qualifications
- 5 years of experience in Payment Integrity Audit & Recovery Programs

- Strong analytical skills, with attention to details and ability to problem solve

- Attention to detail and ability to problem solve

- Project Management experience

- Data driven problem solving

- Advanced skills in Microsoft Excel, Word, Teams and other standard business tools

- Excellent oral and written communication skills

- Ability to multiple tasks in a fast-paced environment with attention to detail.

- Capable of building and maintaining strong interdepartmental working relationships

- Reliable, responsive, and accountable, with a strong sense of ownership for assigned follow-up tasks.

Education and Required Certification:

- Bachelor’s degree preferred or equivalent work experience in payment integrity services

EXL Offers:

- EXL Health offers an exciting, fast-paced, and innovative environment that brings together a group of sharp and entrepreneurial professionals who are eager to influence business decisions.

- From the very first day, employees have the opportunity to work closely with experienced healthcare, quality, and audit professionals.

- You can expect to learn many aspects of the healthcare Payment Integrity business while building effective teamwork, communication, organization, and time-management skills.

- This role provides valuable exposure to healthcare audit operations, onboarding coordination, manager support, and the systems and processes that help teams operate efficiently.

- The unique experiences gained at EXL Health set the stage for further growth and development.

*The posted base salary range is the hiring base salary range for this role. Final offers are based on several factors, including: the candidate's skills and experience, internal pay equity, work location, market conditions for the role, and the specific scope and responsibilities of the position.