Job Summary
A healthcare company is seeking a Telecommute Healthcare Economic Consultant.
Core Responsibilities Include:
- Researching and developing potential claim overpayment hypotheses
- Utilizing data mining tools (i.e. SQL, Access, Excel) in order to analyze data
- Presenting the findings for solution approval in a clear and concise manner
Applicants must meet the following qualifications:
- 3+ years of data analysis experience
- 3+ years of experience in healthcare (billing, coding, auditing claims)
- 3+ years of experience with claims processing or adjudication systems
- Strong computer skills: MS Excel, Word, PowerPoint
- Working knowledge of Medicare rules and regulations and knowledge of procedure and diagnosis codes
- Knowledge of Medicare, Medicaid and / or Commercial health plan and payment methodology