United States onlySalary Range: $215,000 - $290,000
As Medical Director – Payment Integrity at EXL Health, you sit at the intersection of clinical practice, payor operations, and financial stewardship. You leverage your clinical expertise, managed care experience, and deep understanding of payer guidelines, regulatory requirements, and industry-standard policiesto ensure claims are paid accurately, appropriately, and in full compliance with state, federal and plan-specific policies. In this role, every decision influences how healthcare dollars are safeguarded and allocated, making you a key clinical authority within EXL’s Payment Integrity team.
You collaborate closely with senior leaders, analytics partners and Operations teams to connect clinical insight with business strategy. When coding changes, regulatory updates, or new data patterns emerge, you help interpret their clinical impact and shape how our payment integrity programs respond, contributing to the evolution of new concepts and solutions.
CA, FR + 5 more