Salonkee Sales Representative – Wolfsburg
Salonkee
Grow Salonkee’s salon software business across the Wolfsburg region by building relationships with local salons. Demonstrate the product and guide prospects through the sales process.
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EXL एक व्यावसायिक परामर्श और सेवाएँ प्रदान करने वाली कंपनी है, जो संगठनों को डेटा, विश्लेषण और प्रौद्योगिकी का उपयोग करके संचालन में सुधार करने और बेहतर निर्णय लेने में सहायता करती है। इसके कार्यों में संचालन प्रबंधन, निर्णय विश्लेषण और डिजिटल रूपांतरण शामिल हैं। कंपनी को स्वास्थ्य सेवा, बीमा, वित्त और लॉजिस्टिक्स के क्षेत्रों में ग्राहकों का सहयोग करने का अनुभव है। EXL डेटा विज्ञान को व्यावहारिक व्यावसायिक विशेषज्ञता के साथ जोड़कर ऐसे समाधान विकसित करती है, जो प्रत्येक संगठन के लक्ष्यों, संचालन मॉडल और उद्योग-परिस्थिति के अनुरूप होते हैं।
Senior Manager, Claims Data Mining and Payment Integrity
Lead claims analytics and exploratory data mining to detect Medicare, Medicaid, and commercial overpayments. Turn payment-integrity expertise into practical solutions for analytics and product teams.
विवरण
- Lead exploratory analysis of paid claims data to uncover utilization patterns, anomalies, and potentially inappropriate or excessive payments
- Apply expertise in CMS regulations, contract interpretation, reimbursement, and claims workflows to direct data-mining and investigative work
- Reverse-engineer claims outcomes to identify the root causes of payment issues and system behavior
- Convert operational and claims findings into actionable use cases and solution concepts for analytics and product teams
- Work with analytics, product, and strategy partners to align solutions with real-world claims operations
- Assess analytical findings against practical claims and payment conditions
- Present insights, risks, and opportunities clearly to technical and non-technical audiences
- Help improve and scale claims monitoring and overpayment-detection capabilities
आवश्यकताएँ
- At least 10 years of U.S. healthcare claims experience, with a strong focus on adjudication and payment-integrity data mining
- Broad experience working with Medicare, Medicaid, or commercial healthcare business
- Established expertise in end-to-end claims review, auditing, and payment integrity
- Ability to detect patterns, anomalies, and inappropriate payments in large claims datasets
- Strong analytical judgment and the ability to connect operational expertise with data science
- Experience working across analytics, product, strategy, and compliance functions
- Excellent communication skills for explaining complex claims concepts to varied audiences
- Previous participation in payment-integrity data-mining or recovery initiatives
- Experience supporting or developing non-clinical claims analytics or data-mining programs
- Deep understanding of CMS rules, contract interpretation, reimbursement, and claims workflows
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