Medical Management Research Analyst

Job Summary

To enhance claims payment accuracy and integrity, the full-time remote Medical Management Research Analyst will identify, develop, and implement solutions while collaborating with stakeholders and analyzing claims data.

Key responsibilities

• Identify and scope payment integrity initiatives to prevent unnecessary spending
• Analyze claims data and develop implementation assessment plans
• Collaborate with internal and external stakeholders to optimize payment processes

Required qualifications

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