EXL is a business consulting and services company that helps organizations use data, analytics, and technology to improve operations and make better decisions. Its work includes operations management, decision analytics, and digital transformation, with experience supporting clients in healthcare, insurance, finance, and logistics. EXL combines data science with practical business expertise to develop solutions tailored to each organization’s goals, operating model, and industry context.
Senior Operations Executive – Healthcare Claims Receivables (Hybrid, Chennai)
Manage healthcare claims receivables, denials, insurance follow-ups, cash posting, and contractual adjustments while supporting HIPAA-compliant recovery and SLA-based resolution.
Description
- Review assigned receivables portfolios to identify unresolved claims
- Coordinate with insurers to resolve outstanding and denied claims
- Obtain additional information needed to resolve claims
- Resolve claims within established timelines and Service Level Agreements (SLAs)
- Conduct website checks and process non-callable denials
- Handle website-related claims using coding team responses
- Process non-callable, demographic, and eligibility denials
- Meet daily productivity and quality targets
- Prioritize aging claims to reduce delays and prevent revenue loss
- Review claims that insurance companies have not paid
- Investigate insufficient or unclear patient insurance information
- Escalate complex collection issues to management
- Address patient billing queries and update account information
- Post cash and write off contractual adjustments
- Achieve daily, weekly, and monthly individual targets
Requirements
- Graduation in any discipline
- 3–6 years of BPO experience
- Experience with US healthcare accounts receivable is preferred
- Strong written documentation and verbal communication skills
- Computer literacy
- Experience with healthcare accounts receivable processes
- Follow applicable guidelines and rules when contacting insurers to maintain confidentiality and HIPAA compliance