医疗理赔数据分析师
Healthcare Claims Data Analyst
高级医疗理赔数据分析师将支持业务团队，基于历史数据评估产品/服务的使用趋势，如护理管理趋势、理赔使用情况、会员属性等，以开发成本效益高的优质产品/服务。理想的候选人能够获取、整理并开展医学健康理赔数据的研究与分析，主要目的是识别根本原因，具备积极主动的思维和自我驱动力，享受在快节奏且具有挑战性的环境中工作，并具备独立工作的能力。
候选人应具备广泛的医疗理赔领域经验与知识，包括住院、门诊、SNF、ESRD、康复、心理健康、居家护理和PBM等领域。有之前的理赔支付经验将是有益且推荐的。了解医学理赔术语和保险术语。建议具备提供方计费实践、理赔系统限制和提供方合同条款的经验。建议/鼓励具备预付和后付经验。
- 该职位薪资范围为：93,900 - 154,200 美元
有关福利及我们提供的更多信息，请访问我们的网站
最初发布于喜马拉雅山
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The Senior Healthcare Claims Data Analyst will support the business team in evaluating trends on utilization of products / services based on historical data - such as care management trends, claim utilization, member attributes, to develop cost effective quality product / services. The ideal candidate retrieves, organizes and performs research/analysis on Medical Health Claim data primarily to identify root cause and is a proactive thinker, self-starter, who enjoys working in a fast-paced and challenging environment with the ability to work independently.
Candidate should have experience and knowledge across a breadth of health care claim domains. This includes Inpatient, Outpatient, SNF, ESRD, Rehab, Behavioral Health, Home Health, and PBM areas. Previous claim payment experience would also be beneficial and recommended. Understanding of Medical claim terminology and insurance terminology. Experience with provider billing practices, claim system limitations, and provider contracting terms are highly recommended. Experience in Pre Pay and Post Pay is recommended/encouraged as well.
- Salary Range for this role is: $93,900 - $154,200
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Originally posted on Himalayas