Harness the power of your healthcare data

Pharmacy Payment Integrity Analyst

AnalystAnalystFull TimeRemoteTeam 1-10Since 2016H1B No SponsorCompany Site LinkedIn

Location

United States

Posted

86 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 • Review claims history, medical reviews, provider files, etc. • 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
Detail-oriented with excellent communication skills (oral presentations and written) and interpersonal skills
Strong critical-thinking, communication and attention to detail skills