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Senior Data Mining Auditor
Job Summary
A company is looking for a Senior Data Mining Auditor who will identify medical cost savings for healthcare insurance clients through data mining strategies and enhancements.
Key Responsibilities
- Support the development and maintenance of operational reports and dashboards for the Payment Integrity team
- Produce detailed data mining reports and extract critical information to inform stakeholders
- Develop quality control processes and utilize data analytics to reveal business insights and savings opportunities
Required Qualifications
- Seven years of medical claims investigation or data mining experience, with five years in a leadership role
- Relevant medical billing and coding certification and a bachelor's degree in a relevant field are preferred
- Minimum of a high school diploma or GED
- Experience with software platforms such as MS SQL Server and Power BI
- Proficiency in medical terminology and knowledge of coding guidelines and healthcare regulations
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COMPLETE JOB DESCRIPTION
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