Job Summary

A healthcare company is searching for a person to fill their position for a Telecommute Payment Integrity Concept Researcher.

Must be able to:

• Research and develop potential claim overpayment hypotheses
• Use data mining tools (i.e. SQL, Access, Excel)
• Run initial PL SQL queries to ensure hypothesis is worth developing further

Qualifications Include:

• 2+ years of experience in healthcare (billing, coding, auditing claims)
• 2+ years of medical claims
• 2+ years of data analysis experience
• 2+ years of experience with claims processing or adjudication systems
• Maintaining working knowledge of coding standards, billing rules and regulations
• Knowledge of health plan and payment methodology