Medical Management Research Analyst

Job Summary

A company is looking for a Research Analyst - Medical Management, Remote.

Key Responsibilities

• Identify, develop, and implement solutions to enhance claims payment accuracy and integrity
• Analyze claims data and scope payment integrity initiatives to reduce unnecessary spending
• Collaborate with stakeholders to optimize payment processes and provide actionable recommendations

Required Qualifications

• Bachelor's Degree, or 3 years equivalent experience
• 3 years experience with performance improvement/organizational change tools
• 3 years experience working with large data sets and analytics teams
• 3 years claims processing experience within the health insurance industry
• Experience with reimbursement methodologies and medical coding practices