Employer Industry: Healthcare Services

Why Consider this Job Opportunity:

- Competitive salary up to $103,103
- Opportunity for career advancement and growth within the organization
- Thorough analysis and research responsibilities
- Close collaboration with internal and external stakeholders
- Involvement in cross-functional working teams
- Utilization of strong analytical and problem-solving skills

What to Expect (Job Responsibilities):

- Identify and implement new concepts to target claim overpayment scenarios
- Perform analysis on claims, provider data, enrollment data, and medical policies
- Track and report progress of cost avoidance/overpayment recovery concepts
- Review claims edit concept results for quality assurance
- Stay updated on changes to payment rules and update existing system edits

What is Required (Qualifications):

- Bachelor's Degree in Health Information Management, Data Analytics, or equivalent work experience
- Certified Professional Coder preferred
- 3 years of relevant experience in healthcare claims reimbursement methodologies and data analysis
- Strong analytical and problem-solving skills
- Effective written and oral communication skills

How to Stand Out (Preferred Qualifications):

- Master's Degree in Health Administration, Information Systems, or related field

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