{"id":2575678,"url":"https://alion.io/job/exl-trainer-quality-analyst-data-mining-payment-integrity","title":"Trainer / Quality Analyst – Data Mining, Payment Integrity","company":{"id":38016,"name":"EXL","domain":"exlservice.com","url":"https://alion.io/company/exl","size_band":"5000+","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Oracle","truth_index":{"grade":"B","score":81,"open_postings":67,"ghost_share":0,"stale_share":0.94,"repost_share":0,"time_to_fill_p50_days":8,"computed_at":"2026-10-15T05:46:00Z"}},"role":"Education","role_family":"Education","seniority":"senior","employment_type":null,"work_mode":"remote","remote_scope":"stated_countries","remote_scope_basis":"posting_text","remote_working_hours":null,"hiring_geo_confidence":"explicit","locations":[],"countries":[],"hiring_countries":["US"],"hiring_countries_total":1,"salary":{"min":75000,"max":90000,"currency":"USD","period":"year","gross":null,"usd_annual":90000},"salary_estimate":null,"experience_years_min":5,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"HIPAA","optional":false},{"name":"Microsoft Excel","optional":false},{"name":"Outlook","optional":false}],"status":"live","first_seen_at":"2026-10-12T12:28:15Z","employer_posted_date":"2026-10-12","last_verified_at":"2026-10-15T08:07:05Z","board_verified":true,"closed_at":null,"days_open":2,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":2},"description":"This position reviews completed audit findings, validates overpayment opportunities, confirms claim repricing accuracy and supporting documentation, develops and supports training plans and learning resources, and ensures audit work aligns with client requirements, coding guidelines, pricing rules, and claim payment methodologies. The ideal candidate brings strong healthcare claims knowledge, analytical thinking, attention to detail, virtual training capability, effective communication skills, and the ability to provide clear feedback, coaching, and training support that strengthens auditor performance, continuous improvement, and recovery outcomes.\nSalary Range: $75,000 - $90,000 (based on experience, skills, and qualifications)\nLocation: 100% Remote (U.S.-based)\nUp to 10% annual travel (for team meetings and limited client onsite engagements.)\nFor more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits\n Facilitate training sessions, refresher education, coaching discussions, and one-on-one support to improve auditor performance, audit consistency, documentation quality, and compliance with applicable review standards.\n\nProvide training support for new and existing Data Mining auditors by explaining audit procedures, quality expectations, error trends, common claim scenarios, repricing concepts, and appropriate documentation practices.\n\nCreate and maintain structured Data Mining learning resources, including job aids, tutorials, process documentation, knowledge checks, and refresher content to support onboarding, ongoing education, and consistent audit execution.\n\nAssess trainee and auditor understanding through audit results, quality trends, knowledge checks, and observed performance to identify learning gaps and recommend targeted coaching or refresher training.\n\nPerform quality control reviews of completed Data Mining audit findings to validate claim accuracy, payment methodology, recovery opportunity, and compliance with client-specific requirements.\n\nReview supporting documentation, including provider contracts, fee schedules, client claim systems, pricing references, coding guidelines, and audit notes to confirm findings are fully supported and clearly documented.\n\nValidate complex claim repricing completed through Data Mining audit processes using applicable client claims systems, pricing tools, CMS guidelines, coding resources, and program-specific procedures.\n\nMonitor, analyze, and report error trends, root causes, pass/fail outcomes, and recurring issues impacting payment accuracy, audit quality, and operational performance.\n\nRecommend corrective actions, training opportunities, and quality improvement initiatives to reduce payment errors, strengthen audit consistency, and improve overall performance.\n\nEvaluate current audit processes, controls, procedures, and Data Mining concepts; review query-driven audit outputs to ensure effectiveness, consistency, efficiency, compliance with quality expectations, and alignment with recovery outcomes.\n\nPartner with audit leadership, trainers, quality teams, and subject matter experts to clarify requirements, support calibration efforts, resolve training or quality gaps, recommend process improvements, and contribute to procedure updates and special projects.\n\nEnsure audit work aligns with client, program, regulatory, HIPAA, and company requirements while maintaining confidentiality and compliance standards.\n\n High School Diploma required.\n\nMinimum 5+ years of experience in medical claims, healthcare auditing, Payment Integrity, coding, claim quality review, or related healthcare operations.\n\nStrong understanding of complex medical claim processing, provider payment methodologies, claim systems, and audit documentation requirements.\n\nAbility to interpret client requirements, provider contracts, fee schedules, coding guidelines, pricing rules, and healthcare compliance standards.\n\nStrong verbal and written communication skills with the ability to provide clear, professional, and actionable feedback.\n\nAbility to work independently, manage multiple priorities, meet deadlines, and maintain accuracy in a production-based environment.\n\nAbility to develop or deliver virtual training materials, coaching plans, process guidance, job aids, and knowledge checks for healthcare claims, auditing, quality review, or Payment Integrity teams.\n\nAbility to translate complex claims, audit, repricing, quality, and compliance concepts into clear virtual training content that supports different learning levels.\n\nKnowledge and Skills\nExtensive knowledge of medical claims processing, healthcare reimbursement, provider payment logic, and overpayment recovery concepts.\n\nStrong understanding of CMS pricing and reimbursement guidelines, provider contract interpretation, fee schedules, coding resources, and healthcare compliance standards.\n\nKnowledge of CPT, HCPCS, ICD-10-CM, and medical coding methodologies; ICD-9 knowledge helpful where applicable.\n\nAbility to review query-driven audit outputs and understand how Data Mining logic supports claim selection, overpayment identification, audit validation, training needs, and quality outcomes.\n\nStrong analytical and critical-thinking skills with the ability to identify patterns, root causes, quality trends, process improvement opportunities, and corrective actions.\n\nStrong understanding of quality assurance principles, audit accuracy standards, error prevention, and structured review criteria.\n\nEffective written and verbal communication skills with the ability to provide clear, constructive feedback and collaborate professionally with auditors, leaders, trainers, and client-facing teams.\n\nStrong trainer presence with confident virtual facilitation, presentation, and instructional delivery skills for remote group training, refresher education, coaching discussions, and one-on-one learning support.\n\nStrong training development skills, including the ability to build organized virtual learning content that supports onboarding, audit accuracy, quality readiness, and employee performance.\n\nAbility to assess learner comprehension, identify training gaps, and adapt virtual training content to different experience levels based on audit results, knowledge checks, and observed performance.\n\nAbility to coach auditors through audit results, quality trends, documentation issues, and corrective actions to support improved performance and consistent audit outcomes.\n\nProficiency with Microsoft Excel, PowerPoint, Outlook, Word, spreadsheets, databases, and data analysis tools.\n\nDemonstrated commitment to accuracy, quality, attention to detail, confidentiality, and compliance with client, company, and healthcare requirements.\n\nPreferred Qualifications\nCollege degree preferred.\n\nCPC (Certified Professional Coder) or other nationally recognized coding certification preferred. Relevant experience may be considered in lieu of certification.\n\nExperience with Payment Integrity, healthcare reimbursement, or overpayment recovery audits preferred.\n\nPrior experience performing quality reviews, claim audits, or audit validation strongly preferred.\n\nExperience applying quality criteria, audit scorecards, accuracy standards, or structured quality review guidelines preferred.\n\nExperience with healthcare claim systems and industry tools such as FACETS, NASCO, Encoder Pro, TrueCode, 3M, Webstrat/Webtrat, and applicable pricers preferred.\n\nPrior experience creating virtual training programs, job aids, assessments, and support tools for healthcare claims, audit, quality, or Payment Integrity teams preferred.\n\nThis role is ideal for a detail-oriented training and quality professional who enjoys developing virtual learning resources, coaching auditors, validating audit accuracy, identifying trends, and helping teams improve outcomes.\nWhat we offer:\nEXL offers an exciting, fast paced, and innovative environment, which brings together a group of sharp and entrepreneurial professionals who are eager to influence business decisions. From your very first day, you get an opportunity to work closely with highly experienced, world class Healthcare consultants\nYou can expect to learn many aspects of businesses that our clients engage in. You will also learn effective teamwork and time-management skills-key aspects for personal and professional growth\nWe provide guidance/coaching to every employee through our mentoring program wherein every junior-level employee is assigned a senior-level professional as an advisor\nThe sky is the limit for our team members. The unique experiences gathered at EXL sets the stage for further growth and development in our company and beyond\nThe 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.","description_format":"text","description_chars":9010,"description_truncated":false,"requirements":{"experience_years_min":5,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":{"level":"high_school","optional":true},"security_clearance":false,"languages":[]},"benefits":["Equity"],"hiring_locations":[{"name":"United States","iso":"US","kind":"country"}],"hiring_excludes":[],"relocation_offered":false,"industries":["Business Process Outsourcing (BPO)","AI Consulting & Integration","Analytics & BI Consulting"],"lifecycle":[{"event":"open","at":"2026-10-15T00:00:56Z"}],"visa":[{"country":"US","licensed_sponsor":true,"evidence":"H-1B filings in 12 months: 281 · green card filings: 17","filings_12m":281,"filings_prev_12m":395,"green_card_filings_12m":17,"median_offered_wage_usd":128641,"route":null,"cap_exempt":false,"checked_at":"2026-10-03T21:08:04+00:00","sources":["US Department of Labor: LCA disclosure data (H-1B, H-1B1, E-3)","US Department of Labor: PERM disclosure data (green cards)"],"filings_for_role_12m":0}],"liveness":{"score":61,"band":"ok","label":"Likely open","p_open":1,"p_active":0.608,"p_room":1,"age_days":2,"expected_fill_days":8,"reasons":["conf:1","stale_co","velocity","win:early","comp:brand"],"computed_at":"2026-10-15T05:46:00Z"},"pay":{"stated_usd_annual":90000,"is_top_pay":false},"html_url":"https://alion.io/job/exl-trainer-quality-analyst-data-mining-payment-integrity","json_url":"https://alion.io/job/exl-trainer-quality-analyst-data-mining-payment-integrity.json","meta":{"generated_at":"2026-10-15T08:38:09Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","about":"Alion is a live layer of people, companies and AI agents: who they are, whether they are real and active right now, what they do and how to work with them, readable by people and by agents and paid per call.","catalog":"https://alion.io/catalog.json","usage":{"tier":"crawler_verified","counted_by":"address","units_charged":1,"used_today":12965,"day_limit":null,"remaining_today":null,"minute_limit":300,"resets_at":"2026-10-16T00:00:00Z"}},"offers":[{"id":"company.slices","title":"One company in depth, by slice","status":"live","price":{"credits":0.02,"usd":0.002,"plus_per_slice":{"credits":0.05,"usd":0.005}},"unit":"per company, plus each slice with data","note":"the employer in depth","call":{"mcp_tool":"get_company","arguments":{"id":38016},"rest":"https://alion.io/mcp/rest/get_company?id=38016"},"human":"https://alion.io/catalog?offer=company.slices&for=job%2Fexl-trainer-quality-analyst-data-mining-payment-integrity"},{"id":"market.stats","title":"A market slice: pay, demand and time to fill","status":"live","price":{"credits":1,"usd":0.1},"unit":"per slice","note":"pay, demand and time to fill for this role and place","call":{"mcp_tool":"market_stats"},"human":"https://alion.io/catalog?offer=market.stats&for=job%2Fexl-trainer-quality-analyst-data-mining-payment-integrity"},{"id":"job.search","title":"Open jobs by role, technology, place, pay and visa","status":"live","price":{"credits":0.02,"usd":0.002},"unit":"per posting in a list","note":"similar open postings","call":{"mcp_tool":"search_jobs"},"human":"https://alion.io/catalog?offer=job.search&for=job%2Fexl-trainer-quality-analyst-data-mining-payment-integrity"},{"id":"company.verify","title":"Is this company real and active right now","status":"pilot","price":null,"unit":"per company","request":{"url":"https://alion.io/catalog/request","method":"POST","body":"{\"offer\": \"company.verify\", \"for\": \"job/exl-trainer-quality-analyst-data-mining-payment-integrity\", \"note\": \"what you need it for\"}"},"human":"https://alion.io/catalog?offer=company.verify&for=job%2Fexl-trainer-quality-analyst-data-mining-payment-integrity"}]}