SmartLight Analytics

Harness the power of your healthcare data

Lead Pharmacy Payment Integrity Analyst

AnalystAnalystFull TimeRemoteTeam 1-10Since 2016H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

52 days ago

Salary

Not specified

Bachelor Degree4 yrs expExperience acceptedEnglish

Job Description

• Identify and investigate healthcare billing activities leading to improper payments • Review claims data and conduct analysis to look for patterns of potential improper payments • Conduct data analysis to review claim and case history • Identify and resolve issues related to data discrepancies, missing data, or inconsistencies within clinical datasets

Job Requirements

  • Bachelor's degree or 4 – 6 years of equivalent work experience in healthcare administration, billing, claims adjudication, clinical auditing, payment integrity operations and/or healthcare reimbursement
  • CPC, CCS or other relevant clinical/coding certifications strongly preferred
  • Strong knowledge of clinical terminology, medical procedures, and healthcare workflows
  • Ability to be concise, independent and provide defensible decisions in writing
  • Detail-oriented with excellent communication skills (oral presentations and written) and interpersonal skills
  • Strong critical-thinking, communication and attention to detail skills
  • 3+ years of experience working in the group health business or experience in a healthcare provider’s practice

Benefits

  • Health insurance
  • Retirement plans
  • Paid time off
  • Flexible work arrangements
  • Professional development

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