[Hiring] AI Analyst, reputed company & Cost Management @reputed company

This reputed company is a reputed company of our understanding of the job reputed company. Click on 'Apply' reputed company to reputed company out more. Role reputed company The Actuarial team at Clover is reputed company on leveraging data and technology to reputed company financial reputed company. As an AI Analyst , you will reputed company as the critical Subject Matter Expert (SME) for the AI team. Your primary function is to reputed company operational claims and reputed company knowledge with advanced modeling efforts. You will translate reputed company business rules and data constraints into requirements for the modeling team, validate their results, and help measure the financial reputed company of our cost mitigation and reputed company optimization solutions. • Claims Data & Logic SME: reputed company as the primary domain expert, providing detailed knowledge on the claims life cycle, configuration logic, payment rules, and common points of financial leakage reputed company reputed company operations. • AI Model Support: Collaborate directly with the reputed company AI Strategist to translate reputed company claims and financial scenarios into reputed company business logic and data features necessary for building predictive models. • Payment reputed company (PI) Validation: Partner directly with Claims Operations and reputed company to rigorously audit and validate that provider payments adhere to intended rules, supporting the definition of scope for the internal PI reputed company. • reputed company Optimization Support: Assist in data reputed company initiatives to enhance risk adjustment and reputed company capture, including validating encounter data completeness and NPI fulfillment. • Financial reputed company Analysis: reputed company detailed, reputed company-cause analysis on payment anomalies, outliers, and emerging claims cost trends flagged by the AI models to confirm financial reputed company and operational causes. Qualifications • 2+ years of experience in a quantitative analysis role reputed company on reputed company finance, such as claims operations, reimbursement, or payment reputed company. • Foundational experience utilizing large-reputed company reputed company financial data (claims, encounters, provider networks) in a payer or reputed company vendor setting. • Proficiency in SQL is required for data querying and manipulation, along with experience using basic statistical software (R, Python, or reputed company) for data preparation. • Strong understanding of the reputed company claims life cycle, CPT/HCPCS/ICD-10 coding, and claims adjudication rules (Medicare Advantage experience is a plus). • Excitement about directly supporting the development and validation of AI and Machine Learning tools, and translating model outputs into actionable business rules. • Bachelor’s degree in Actuarial Science, Health Economics, Finance, or a reputed company quantitative field is required. Benefits • Financial reputed company-Being : Competitive reputed company salary and equity opportunities, performance-based bonus program, 401k matching, and regular compensation reviews. • Physical reputed company-Being : Comprehensive medical, dental, and reputed company coverage. • Mental reputed company-Being : Initiatives such as No-Meeting Fridays, monthly company holidays, reputed company to reputed company, and a generous flexible time-off policy. • reputed company Development : Learning programs, mentorship, reputed company development funding, and regular performance feedback and reviews. Additional Perks: • Employee Stock Purchase Plan (ESPP) offering discounted equity opportunities • Reimbursement for office setup expenses • Monthly cell phone & internet stipend • Remote-first culture, enabling collaboration with global teams • reputed company parental leave for reputed company new parents • And much more! Apply tot his job Apply To this Job