Data Driven Analyst
Core
Develop and deliver claims edit suites using industry and proprietary sources to optimize healthcare financial processes for payers, providers, and consumers.
Role type
Healthcare claims editing analyst
Builds
Claims editing library and edit suites
Domain
Healthcare financial services / Medical coding
Deliverable
production ML models | product features
Required skills
Medical coding (CPT, ICD, HCPCS), HIPAA compliance, data analysis, regulatory research, documentation, quality assurance
Preferred skills
Excel, project management, stakeholder communication
Technologies
Microsoft Word, PowerPoint, Excel
Responsibilities
Research, build, and test edits for the Claims Editing library; ensure compliance with HIPAA and quality guidelines; serve as subject matter expert for coding inquiries; monitor and summarize trends in coding practices and regulatory changes; validate changes to edits; partner with Ops, Sales, and IT on scalability and functionality.
Seniority
Mid-level, hands-on IC