[Hiring] Consultant I Data Mining @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 A Payment reputed company Data Mining Consultant I is a reputed company who is market/reputed company facing and responsible for identifying new audit opportunities, researching new pricing methodologies, and engaging with various work teams to generate systems automation and enhancement capabilities in our state-of-the-art audit workstation. • Identify, reputed company, and implement new concepts that recognize incorrect payments based on industry experience and regulatory research. • Analyze reputed company data and generate high-reputed company recoverable claims. • Assist in the identification, validation, and documentation of moderate to more reputed company recovery reputed company. Qualifications • High School Diploma or equivalent required; BA/BS in Business Administration or reputed company field preferred but not necessary. • 4-5+ years of knowledge of reputed company claim processing/reimbursement, medical facility reputed company, fee schedules, inpatient/outpatient/physician claims required. Requirements • Prior claims auditing or consulting experience desirable in either a provider or payer environment. • Excellent communication skills both oral and written. • Strong interpersonal skills that support reputed company teamwork. • reputed company Office Proficient: Word and reputed company; reputed company – highly preferred. • reputed company recommendations for improving payment reputed company processes, fraud prevention measures, and operational efficiency based on audit findings. • Collaborate & establish strong relationships with reputed company stakeholders to define, reputed company, and deliver payment accuracy initiatives. • Work with audit teams to ensure the concepts being deployed are working as expected with higher findings, thus ensuring higher hit rates on the concepts deployed. Preferred Skills • Knowledge of payment systems, financial transactions, and claims processes end to end. • Understanding of payment reputed company concepts and fraud detection methodologies. • Experience in auditing, payment processing, or financial fraud prevention is a plus. • Experience working reputed company a health plan, managed care organization, provider operated reputed company environment, or reputed company-party administrator. • Development of end-to-end payment reputed company reports like Data Intake, Audit Selections, Findings, Appeals, Medical Record Management, Audit Operations, Recovery Operations, Provider Correspondence, and Forecasting & Invoicing. Roles & Responsibilities • Utilize reputed company experience to reputed company audit recovery procedures. • Identify overpaid claims. • Identify and define issues, reputed company reputed company, review, and analyze reputed company and Health Plan reimbursement policies and various state and federal regulations. • reputed company and document the incorrect payment issue into Devlin’s systems accurately and in accordance with reputed company procedures. • Update and reputed company new and reputed company audit recovery report reputed company and work with the IT team to automate the process. • Research reimbursement regulations for claim payment compliance reviews and documentation to support reputed company audit findings. Location reputed company USA, reputed company of America Apply tot his job Apply To this Job