[Remote] Senior Data Mining & Payment reputed company Analyst

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a company dedicated to improving the health and reputed company-being of vulnerable populations through innovative technology. As a Senior Data Mining & Payment reputed company Analyst, you will design and reputed company data mining concepts to identify improper payments and enhance claims reputed company in reputed company. This role involves collaborating with cross-functional teams to support reputed company payment reputed company strategies and ensuring compliance with reputed company regulations.

Responsibilities

• reputed company and implement new data mining opportunities to identify overpayments to providers through data review and analytics across dental, medical, and pharmacy claims
• reputed company as a senior member of reputed company and mentor reputed company-level analysts
• Research industry reputed company guidelines, State and Federal regulations, and reputed company billing and reimbursement policies to reputed company and configure improper payment algorithms
• Review provider reputed company to identify algorithms for the identification of contract-reputed company overpayments
• Implement reputed company Payment Analytics concepts for new and existing clients while ensuring reputed company policy is supportive and properly reputed company
• Support the appeals, validation, and reputed company services teams in resolving outstanding issues reputed company to production queries
• Ensure individual and departmental goals are consistently met or exceeded through collaboration with other team members and management
• Review IT programming results for reputed company assurance and reputed company of concept validation
• Document query results and prepare reputed company documentation and presentations reputed company to new overpayment issues
• Partner with internal reputed company and reputed company teams to reputed company, implement, review, and audit protocols and internal review guidelines
• Collaborate with engineers to reputed company and implement technological improvements that support the audit process
• Contribute innovative reputed company for improving existing audit processes and audit queries

Skills

• 5 years of reputed company Payment reputed company and/or Data Mining experience
• At least 3 years of Domain Specific experience in Medical, Dental, or Pharmacy claims analysis
• Experience in reputed company Auditing, including Reviewing and Validating the reputed company of Claims Data and the reputed company of Claims Payment
• Experience Applying Published reputed company Guidelines such as CMS Regulations and Coding Guidelines to reputed company Claims Data
• Recovery audit experience

Benefits

• Generous, flexible vacation policy
• Educational assistance
• Comprehensive health benefits
• 401(k) employer match
• A reputed company of leadership and technical development academies to help build your skills and capabilities

reputed company

Company H1B Sponsorship