Medical Claims Analyst

Data analysis, Big data, CPT, ICD-10, Health insurance, Attention to detail, Medical terminology, Data integrity, HIPAA, Medicaid, Medicare, Microsoft Excel, Health care, Normalization, NDC, Reporting, SQL, Data manipulation, Organized, QA, Recovery, Claims
Full Time
Depends on Experience

Job Description

Position Overview:

MSP Recovery, LLC is looking for Medical Claims Data Analyst, Located in Coral Gables, FL. The candidate will be responsible for analyzing medical claims data from multiple providers in a big data environment. Will also oversee quality control of the data sets received throughout the on boarding process.

Job Functions:

  • Must have a strong knowledge of Healthecare, Medical claims and Rx claims, including but not limited experience with HCFA-1500, UB-04, ICD10, NDC codes, DRG reimbursement and 835, 837* EDI-x12 knowledge a plus to effectively perform job function.
  • Analyze and interpret claims information, with a strong understanding of claims adjustments/reversals of various types of medical claims, including Medicare, Medicaid, Commercial, self-insured and subrogation claims.
  • analyze and develop data patterns from a variety of claims data outputs from multiple Health Plans.
  • Proficient in SQL for data-pull and analyze large data from a variety of claims from multiple entities, types of HealthCare Providers.
  • Identify data-integrity issues as they arise and monitor the addition of incoming data from multiple Health Plans data-points.
  • Understanding of Data dictionaries

 

Skills:

  • SQL knowledge with minimum 5 years of experience
  • Excellent analytical, verbal, and written skills must be able to
  • Proficient in creating complex and advanced formulas in Excel and data manipulation for data analysis and normalization.
  • Ability to write and maintain technical specification documentation.
  • Highly organized and detail-oriented
  • Time management and prioritization skills. Capable to work under limited directions and flexible to work in multiple projects as need it.
  • Must be able to communicate effectively, verbally, in writing and follow verbal instructions.
  • Knowledge of healthcare quality, outcomes measurement and reporting
Dice Id : 91099068
Position Id : 7043360
Originally Posted : 2 months ago
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