Company Overview and Culture 

EXL (NASDAQ: EXLS) is a global analytics and digital solutions company that partners with clients to improve business outcomes and unlock growth. Bringing together deep domain expertise with robust data, powerful analytics, cloud, and AI, we create agile, scalable solutions and execute complex operations for the world’s leading corporations in industries including insurance, healthcare, banking and financial services, media, and retail, among others. Focused on creating value from data for driving faster decision-making and transforming operating models, EXL was founded on the core values of innovation, collaboration, excellence, integrity and respect. Headquartered in New York, our team is over 40,000 strong, with more than 50 offices spanning six continents. For information, visit www.exlservice.com.

For the past 20 years, EXL has worked as a strategic partner and won awards in its approach to helping its clients solve business challenges such as digital transformation, improving customer experience, streamlining business operations, taking products to market faster, improving corporate finance, building models to become compliant more quickly with new regulations, turning volumes of data into business opportunities, creating new channels for growth and better adapting to change. The business operates within four business units: Insurance, Health, Analytics, and Emerging businesses. 

We are seeking a highly motivated and detailed oriented Claims Analyst to join our team. This is a hybrid position requiring work in our Hartford, CT office a few days each month.

The hourly rate for this position is $17-21/hr.

As a Claims Analyst, you will play a critical role by investigating, evaluating and reviewing insurance claims to ensure accurate and timely resolution.

Key Job Role

• Reviewing Adjudicated claims:

• • Reviewing claims processing policies and guidelines.
  • Reviewing provider contracts.
  • Analyzing historical overpayment trends.
  • Analyzing claims data to identify outliers.
  • Review and access insurance claims to determine coverage, liability and eligibility.
  • Validate details such as claim ID, Date of service, refund amount and reason for the overpayment from image.
  • Validate claim in system and match all the information from images.

• Conduct thorough investigations, including gathering relevant documentation.
• Collaborate with internal departments, and insurance adjusters to gather necessary information.
• Calculate claims correct payment.
• Maintain detailed and accurate records of claims and related correspondence.
• Assist team members and as and when required.
• Maintain and track overpayment projects in organized and timely manner.
• Adhere to all client and company policies without exceptions.

What you'll need:

• Expertise in US Health Insurance Claims Processing 
• Excellent communication skill for client interaction
• Good basic mathematics, reasoning, and interpretation skills
• Working knowledge of MS Excel for project delivery
• Basic understanding of SQL and VBA
• Experience in reporting and data analysis

Preferred Qualifications:

• US Healthcare experience
• Bachelor’s degree and equivalent work experience.
• Minimum 2-3 years’ experience in claims analysis or a related filed.
• Strong analytical and problem-solving skills
• Proficient in using claims management software and tools.
• Knowledge of insurance industry regulations and practices.
• Ability to work independently and as part of a team.
• Detail oriented with a high level of accuracy.
• Strong organizational and time management skills.
• Commitment to maintaining confidentiality and ethical standards.