Medical Economics Analyst

Job Summary

To support the Payment Integrity team, the full-time Medical Economics Analyst will analyze claims data, identify cost savings opportunities, and validate recoveries while working remotely in New Mexico.

Key responsibilities

• Partner with Payment Integrity and vendor partners to support pre-pay and post-pay initiatives
• Analyze claims data to detect overpayment patterns and billing discrepancies
• Develop methodologies to quantify savings and produce reports on payment integrity performance

Required qualifications

• Bachelor's degree in Actuarial Science, Economics, Finance, Data Analytics, Healthcare Administration, or related field
• 2-5+ years of experience in healthcare analytics, medical economics, or payment integrity
• Strong technical skills in SQL and/or SAS
• Experience with claims data and reimbursement methodologies
• Ability to perform financial and statistical analysis on large datasets