Jobs in the United States

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Senior Consultant – Construction Claims & Cost Analysis
J.S. Held LLC
Miami, FL
Obtained or in the process of obtaining professional license and/or professional certifications (e.g. professional engineer or engineer in training, cost professional, project management…
Added 4 mins ago
Senior Development Test Engineer - Mechanisms
Castelion Corporation
Torrance, CA · Torance, CA
The Senior Development Test Engineer owns the planning, execution, and analysis of tests that turn designs into flight-ready mechanisms. This role sits at the center of engineering,…
Added 5 mins ago
Staff, Mapping Software Engineer
Lucid Motors
Newark, CA
We are seeking a Staff Mapping Engineer to lead the development of large-scale mapping systems
Added 6 mins ago
CO
Security Engineer
City of Alexandria
Alexandria, VA
- $82,050.02 to $144,390.48 USD / year
OverviewThe City of Alexandria's Information Technology Services (ITS) Department is seeking a Security Engineer to join our Information Security team. In this role, you will help…
Added 7 mins ago
Manufacturing Engineer - Materials
USA 3M Company
GA
Identify and implement manufacturing process controls.
Added 10 mins ago
Sr. Systems Integration Engineer, Automated Drive
Rivian
Palo Alto, CA
Added 10 mins ago
Sr. Systems Integration Engineer, Automated Drive
Rivian
Palo Alto, CA
Added 10 mins ago
KS
MSAT Engineer/Specialist
Kelly Services
Bristol, PA
- $52 USD / hour
We are seeking an experienced and highly skilled engineer with expertise in bioconjugation processes, including Antibody Drug Conjugates (ADCs) and Antibody Oligonucleotide Conjugates…
Added 10 mins ago
Senior Pilot - ISR (Deployed Only)
Sierra Nevada Corporation
Shalimar, FL
NOTE: PIC for this purpose is defined as Captain/Aircraft Commander of record, not simply the sole manipulator of the controls. SNC considers only pilot time in fixed wing aircraft toward…
Added 11 mins ago
1
Senior Manufacturing Engineer - Actuators
1X
San Carlos, CA
- $140,000 to $190,000 USD / year
…and DFT feedback, checking tolerances against demonstrated process capability, and driving the changes that make actuators producible at…
Added 13 mins ago
Staff Data Engineer
Abbott Laboratories
Madison, WI
The Staff Data Engineer is a senior, hands-on technical contributor within an Enterprise Data domain, owning technical design and the most complex implementation work for assigned data…
Added 14 mins ago
Process Quality Engineer
THE RITEDOSE CORPORATION
Columbia, SC
The Process Quality Engineer is responsible for supporting Quality Assurance monitoring of manufacturing processes, materials, utilities, and related environmental controls within the…
Added 16 mins ago
Lead Building Engineer
Lincoln Property Company
Boston, MA
The Lead Building Engineer leads and oversees the day-to-day operations and maintenance of building systems, ensuring efficient and safe building performance while supervising engineering…
Added 18 mins ago
Software Quality & Process Architect – Emerging PM
Phoenix Technical Solutions
Pittsburgh, PA
Our company is seeking a high-caliber Software Quality & Process Architect to drive software process engineering, framework design, and quality governance support across our global Controls…
Added 18 mins ago
Software Quality & Process Architect – Emerging PM
Phoenix Technical Solutions
Fort Worth, TX
Our company is seeking a high-caliber Software Quality & Process Architect to drive software process engineering, framework design, and quality governance support across our global Controls…
Added 18 mins ago
Structural Engineer - Industrial/Energy
Kiewit
Lone Tree, CO · Kansas City, KS · Minneapolis, MN · Woodcliff Lake, NJ · Manhattan, NY · Lenexa, KS
Our rapidly growing Industrial Engineering team, which includes process, mechanical, electrical, controls, structural, architectural, geotechnical, and civil disciplines, is a multi-faceted…
Added 19 mins ago
Engineering Manager, Verification and Validation (STATCOM)
GE Vernova
Saratoga Springs, NY
…strong experience in verification and validation of power system controls, real-time testing, and team leadership, along with the ability to work effectively with customers and…
Added 20 mins ago
CO
Program Manager (Capital Improvement Program) - Environmental Services Department
City of San Jose
San Jose, CA
- $134,490.72 to $174,851.04 USD / year
…supervising environmental services specialist, an associate engineer, and engineering technicians. This position works closely with executive management staff and manages consultant program…
Added 20 mins ago
Systems Safety Engineer
Actalent
Middletown, RI
Job DescriptionThe Safety Engineer will utilize both quantitative and qualitative risk assessment techniques to perform comprehensive safety analysis. The role involves analyzing hardware,…
Added 21 mins ago
Pipeline Engineer
Actalent
Versailles, KY
We are seeking an experienced Pipeline Project Engineer to support the design and execution of natural gas, liquids, CO, hydrogen, and other midstream infrastructure projects. This position…
Added 22 mins ago
Product Development Engineer II
PMT Corporation
Chanhassen, MN
…plastic / reconstruction surgery areas. The Product Development Engineer II takes ownership of medium- to large-scale projects from concept through commercialization, ensuring products are…
Added 22 mins ago
A
Automation Engineer (Amazon RME)
Aerotek
Niagara Falls, NY
- $42 to $45 USD / hour
Job Title: Automation Engineer (Amazon RME)Job DescriptionThis role focuses on designing, developing, and implementing automation control systems for industrial processes and warehouse…
Added 23 mins ago
EM
Lead Housekeeper Full Time-101060
ESA Management, LLC
Bensalem, PA
- Full-time
Works directly with the maintenance engineer to perform the guest room preventative maintenance/deep cleaning.
Added 24 mins ago
B
Senior Cloud Security Engineer - R01573020
Brillio
NY
- $120,000 to $130,000 USD / year
Cloud Infrastructure Security: Design, implement, and maintain scalable security controls to protect cloud infrastructure, applications, and enterprise environments.
Added 24 mins ago
Senior Software Architect - Platform
Fiserv Solutions LLC
Alpharetta, GA · Berkeley Heights, NJ
Re-engineer proof-of-concept workloads for enterprise scale, including distributed processing, low-latency serving, batch throughput, fault tolerance, and cost optimization.

Senior Manager - Data Mining & Exploratory Intelligence

United States

*Base Pay Range: $93,900- $154,200 For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits

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Job details

Pay: *Base Pay Range: $93,900- $154,200 For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits
Experience: 10+ years of experience in operations with a strong focus on claims adjudication and payment Integrity
Posting language: English
Posted: Nov 4, 2026

Original job description

We are seeking a seasoned Claims Domain Subject Matter Expert in our CRE – Concept research & exploratory team within our Datamining COE for exploratory claims analysis and support the development of advanced data mining capabilities. This role will focus on identifying claims patterns, anomalies, and potential overpayments across Medicare, Medicaid and commercial platforms, while translating deep operational insight into actionable analytics concepts and solutions.

The ideal candidate brings extensive hands-on claims experience and can “reverse engineer” claims behavior to inform data-driven strategies, tools, and controls.

*Base Pay Range: $93,900- $154,200 For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits

Lead exploratory analysis of claims data to identify utilization patterns, anomalies, and potential overpaid or inappropriate claims
Apply deep knowledge of billing rules, coding, reimbursement, and workflows to guide data mining and investigative efforts
Perform reverse engineering of claims outcomes to understand root causes of payment issues and system behaviors
Translate operational and claims insights into clear use cases, concepts, and solution ideas for analytics and product teams
Partner closely with analytics, product, and strategy teams to ensure solutions align with real-world claims operations
Validate data-driven findings against practical claims and payment realities
Clearly communicate insights, risks, and opportunities to both technical and non-technical stakeholders
Support ongoing refinement and scaling of claims monitoring and overpayment detection capabilities
10+ years of experience in operations with a strong focus on claims adjudication and payment Integrity
Extensive experience across Medicare, Medicaid or/ and commercial platforms
Demonstrated expertise in 360-degree claims review, auditing, and payment integrity
Proven ability to identify patterns, anomalies, and inappropriate payments within large claims datasets
Strong analytical mindset with the ability to bridge operations and data science
Experience collaborating with cross-functional teams (analytics, product, strategy, compliance)
Excellent communication skills with the ability to explain complex claims concepts clearly
Prior involvement in payment integrity, SIU, or recovery initiatives
Experience supporting or designing claims analytics or data mining programs
Familiarity with common coding schemes, authorization models, and provider billing behaviors

*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.

EXL is the indispensable partner for leading businesses in data-led industries such as insurance, banking and financial services, healthcare, retail and logistics. We bring a unique combination of data, advanced analytics, digital technology and industry expertise to help our clients turn data into insights, streamline operations, improve customer experience, and transform their business. Our partnerships with clients are built on a foundation of collaboration – and we’ve been chosen as a partner by nine of the top ten leading US insurance companies, nine of the top 20 global banks, and six of the top ten US health care payers. We function as one team to make your goals our goals, whether that’s unlocking the value of generative AI or embedding analytics into workflows that reduce risk or power your growth. Clients choose EXL as their transformation partner for many reasons. Our geographic diversity make talent all over the world instantly accessible. Digital accelerators enable unmatched speed-to-value, letting you realize results fast. It’s our people that truly set us apart, though, including the 1,500 data scientists we have dedicated to our generative AI practice. And our more than twenty years of experience in delivering business services, garnering stellar client references, and maintaining a solid balance sheet are reassuring to our C-suite clients. Find out for yourself why clients, employees, and analysts think we’re some of the best in the business. Contact us to see how we can help you achieve your goals.

EXL (NASDAQ: EXLS) is a leading data analytics and digital operations and solutions company. We partner with clients using a data and AI-led approach to reinvent business models, drive better business outcomes and unlock growth with speed. EXL harnesses the power of data, analytics, AI, and deep industry knowledge to transform operations for the world’s leading corporations in industries including insurance, healthcare, banking and financial services, media and retail, among others. EXL was founded in 1999 with the core values of innovation, collaboration, excellence, integrity and respect. We are headquartered in New York and have more than 54,000 employees spanning six continents. For more information, visit www.exlservice.com.

EXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates. EXL will only extend a job offer after a candidate has gone through a formal interview process with members of EXL’s Human Resources team, as well as our hiring managers.

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Skills

Data mining
Reverse engineering
Auditing
Regulatory compliance
Communication skills

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