Data Mining Analyst

Description

Requirements The ideal candidate for the Data Mining Analyst opportunity will be an innovative, independent selfstarter with interest in Quality Assurance and Mentoring new employees. Top talent will also possess thorough knowledge of the healthcare reimbursement space. Requirements are as follows 3+ years of directly relevant experience and/or training in both data analysis and healthcare reimbursement.Knowledge of medical and/or pharmacy coding, billing and reimbursement methodologies, e.g. CPT/HCPCS, ICD9/10, DRG (MS, AP, APR), APC, Modifiers, Natl. Correct Coding Initiative, etc. Professional certifications, such as Certified Professional Coder (CPC), Certified Coding Specialist (CCS), etc. are a plus.Proficiency in querybased extraction and examination of data, including basic SQL knowledge and/or expert knowledge of Microsoft Excel.A thorough understanding of health plan adjudication systems and the claims life cycle, i.e. reimbursement logic and its connection to the paid claims data supplied by the health plan for audit. This includes knowledge of facility and professional contracting and its relationship to the adjudication process, prior authorization, utilization management, medical policy, etc.Strong mentoring/training skills to facilitate the movement of discovered content into the production cycle by develop and supporting less experienced team members.A bachelor's degree in a quantitative (finance, statistics, etc.), or healthcarerelated field (preferred, not required).Excellent verbal and written communication skills, with strict attention to detail and accuracy.An independent, figureitout, doityourself approach.Polished interpersonal skills, both within the company and clientfacing.Outstanding organization and prioritization skills, with a strong sense of urgency.A highly curious attitude with a passion to create/innovate.The ability to adapt and thrive in a fastpaced, constantly changing environment.