Job Summary
A healthcare and senior living company needs applicants for an opening for a Remote Claims Specialist.
Must be able to:
- Proactively develop actionable plans for identifying and reporting patterns related to claim denials, payouts of interest, overturned appeals, quality, usage, cost, and other variables
- Cleanse, merge, and analyze HPS claims, authorization, and provider data required to generate dashboards and reports for quality, operational, and financial purposes
- Build complex quantitative and qualitative analysis, documenting current and future state business processes, manage project logistics, and monitor the success of project goals
Skills and Requirements Include:
- Bachelor’s Degree in relevant field
- Minimum of four years’ experience with SQL, SAS, Tableau, Power BI or other analytical and business intelligence tools
- Proficient in Excel
- Experience in an analytics role at a health plan, consulting firm, hospital system or other healthcare related experience
