Claims Data Analyst
Location: Franklin, TN
Duration: 12+ Months
Rate: 50/hr on C2C
Data cleansing, Data sets, Data mining, Claims process, Reporting etc.
Procedure modifiers and procedure location codes for inpatient, out patient, school, mobile unit etc
Mandatory Skills:
· Ability to look at adjudicated claims / membership / eligibility files and :
· Different types of claims: Medicare, Medicaid, Commercial, Professional, Institutional, etc.
· Identify issues with the claims / eligibility data
· Identify solutions to fix data issues
· Use benchmark and supply missing data to facilitate client analytics
Ability to work closely and communicate with client team analysts to:
· Report issues with the data
· Request for missing data from end client
· Share data analysis findings in a structured manner
· Confirm approach to fix data issues in the claims / eligibility files
Ability to work closely and communicate with SQL Developer(s) to:
· Ability to write SQL queries to identify data issues independently (Microsoft SQL Server)
· Ability to analyze business rules, perform data mapping and guide SQL developers to create ETL processes.
Has experience working with:
· Data editing tools (e.g. VEDIT, NOTEPAD++)
· Data profiling / analyzing tools (e.g. SQL Profiler, DQ Analyzer etc)
· SQL queries and databases
· Different Crosswalk tables (used in the health insurance domain)
· Knowledge of automated utilization review, specialty benefit management and data analysis systems
· Excellent verbal and written communication skills and the ability to interact professionally with a diverse group, executives, managers, and subject matter experts
Desired Skills:
· Proficient with MS Office, including Visio
· Ability to understand SQL stored procedures, SAS code
Job Responsibilities:
· Understands claims process and is able to interpret the information in a claim file
· Work with Client Analytics teams and elicit requirements using document analysis, requirements workshops, surveys, and business process descriptions
· Proactively communicate and collaborate with external and internal customers to analyze data needs, as required
· Serve as a Subject Matter Expert in Claims Eligibility and validation processes
You received this message because you are subscribed to the Google Groups "CVMSCRM" group.
To unsubscribe from this group and stop receiving emails from it, send an email to cvmscrm+unsubscribe@googlegroups.com.
To post to this group, send email to cvmscrm@googlegroups.com.
Visit this group at http://groups.google.com/group/cvmscrm.
For more options, visit https://groups.google.com/d/optout.
No comments:
Post a Comment