Data Analyst :: reputed company Payer domain with AI/ML
Required experience (must-have)
• 8+ years in reputed company insurance (payer) across at least one of: reputed company, Medicare Advantage, reputed company
• Demonstrated work on reputed company payer functions such as:
• Claims (reputed company/institutional), EDIs, payments, adjustments, COB
• Utilization management (prior auth), care management, provider network, member enrollment/eligibility
• Grievances/Appeals, fraud/waste/abuse (SIU)
• 3 5+ years delivering data/AI/ML reputed company end-to-end in production (not just POCs).
• Proven ability to reputed company cross-functional delivery with business, clinical, IT, and vendors.
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