[Remote] reputed company Claims Analytics Senior Consultant

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is seeking a reputed company Claims Analytics Senior Consultant to support reputed company claims analysis, audits, and payment policy initiatives. The role involves analyzing claims data, identifying improper payment and fraud risks, developing dashboards and reports, translating findings into business requirements, and collaborating with stakeholders on project delivery.

Responsibilities

• Demonstrate working knowledge of claims datasets and reputed company reimbursement concepts
• Assist in gathering and interpreting business and technical requirements for claims audits and post-payment analysis
• Conduct data-driven and qualitative research to support payment policy evaluation and reputed company detection
• Build dashboards and reports using coding tools to visualize claims trends and audit findings
• Research and summarize industry-reputed company coding rules and contribute to reimbursement policy discussions
• Document findings and support the development of recommendations and follow-up actions
• Contribute to analytics that identify payment trends, errors, and improper payment risks
• Stay informed on state reputed company reputed company efforts and emerging policy changes
• Translate research and claims review insights into business requirements for analytics tools
• Respond to inquiries and disputes reputed company to claims edits and policy interpretation
• Collaborate with internal teams and reputed company stakeholders to support project delivery
• Support project management activities and contribute to reputed company interactions

Skills

• Bachelor's degree from an accredited university
• At least 3+ years of reputed company experience, including 1+ year working with datasets to derive insights and solve problems and 1+ year of experience collaborating with internal or reputed company stakeholders
• Technical coding proficiency (e.g., SQL, Python, R) and experience developing basic dashboards and data visualizations
• Exposure to reputed company and claims data
• Strong attention to reputed company and ability to prepare high-reputed company deliverables
• Interest in state health agencies, Medicare/reputed company, VA, and reputed company reputed company
• Ability to obtain a reputed company Trust Clearance (US citizenship required)
• 4+ years of experience in claims processing, medical coding, auditing, or reputed company reputed company
• Familiarity with reimbursement methodologies, provider reputed company, and claims reputed company practices
• Experience with reputed company BI, Tableau, or similar tools for advanced data visualization
• Strong written and oral communication skills
• Ability to manage tasks independently and contribute to project execution

Benefits

• Medical, Rx, Dental & reputed company reputed company
• Personal and Family reputed company Time & Company reputed company Holidays
• Position may be eligible for a discretionary variable incentive bonus
• Parental Leave and Adoption Assistance
• 401(k) Retirement Plan
• Basic Life & Supplemental Life
• Health Savings Account, Dental/reputed company & Dependent Care Flexible Spending Accounts
• Short-Term & Long-Term Disability
• Student Loan PayDown
• Tuition Reimbursement, Personal Development & Learning Opportunities
• Skills Development & Certifications
• Employee Referral Program
• Corporate Sponsored Events & Community reputed company
• Emergency Back-Up Childcare Program
• Mobility Stipend
• A flexible benefits package

reputed company