Associate, Healthcare Solutions Data – Disputes, Claims & Investigations

Stout • Washington, DC

1d • $74,000 - $135,000

About The Position

The Associate, Healthcare Solutions Data supports healthcare consulting and disputes, claims, and investigations engagements by developing and maintaining audit tools, pricing calculators, case workbooks, and analytical materials. The role analyzes healthcare pricing, reimbursement, payment activity, claims, and future medical expenses, translating complex data and source documents into clear, reproducible calculations, exhibits, reports, and explanations for project teams and expert witnesses.

The position maintains reference libraries and documentation, incorporates regulatory changes and data releases into analytical tools, and applies version control and data-integrity checks. It may also involve researching regulations and opposing analyses, communicating findings to project teams and expert witnesses, and testifying on data-driven analyses when necessary.

The role works with consultants, attorneys, expert witnesses, clinical reviewers, and other specialists. Stout describes a comprehensive Total Rewards program, inclusion and belonging initiatives, professional growth support, flexible work schedules, and a discretionary time off policy. The stated annual compensation range is $74,000–$135,000, with anticipated eligibility for an annual bonus plan.

Requirements

• Experience in quantitative analysis involving healthcare pricing, medical claims, reimbursement, or payment data.
• Strong spreadsheet and analytical modeling skills, including experience building detailed workbooks, calculators, or audit tools.
• Knowledge of commercial, Medicare, and Medicaid fee schedules, pricing methodologies, and medical code descriptions.
• Ability to reconcile claims and payments, identify data discrepancies, and document clear, defensible calculations.
• Experience extracting, organizing, and validating source data and maintaining reference files and version-controlled documentation.
• Ability to research regulatory materials and translate technical findings into accurate exhibits, reports, and explanations.
• Sound judgment when handling confidential information, managing competing requests, and developing custom solutions for varied projects.

Responsibilities

• Build, maintain, and update audit-tool templates, pricing calculators, and case-specific workbooks to reflect regulatory changes, publications, data releases, and project needs.
• Perform commercial, Medicare, and Medicaid pricing analyses and fee schedule calculations, and explain assumptions, methods, and results.
• Conduct pre- and post-audit pricing reviews, payment reconciliations, paid and unpaid claim analyses, and reviews of EOB/EOR information and PIP logs.
• Maintain and customize pre-built Excel-based audit tools, including workbooks, data tables, and calculations for individual cases.
• Develop analyses and rebuttal calculations related to future medical expenses when required by an engagement.
• Gather, extract, organize, and analyze data from external systems, source documents, productions, and Medicare Limited Data Set (LDS) files.
• Maintain reference libraries, including state pricing files, code descriptions, fee schedules, and related source documentation.
• Apply version control, documentation standards, and data-integrity checks to keep analyses accurate, transparent, and reproducible.
• Build custom tools, calculators, and output formats for project teams and outside auditors, including physicians and nurse reviewers.
• Prepare pricing datasets, analytical tables, exhibits, models, report supplements, and summaries for expert reports and testimony.
• Proofread reports, math-check calculations, and research applicable regulations, technical interpretations, and opposing analytical positions.
• Explain analytical methods and findings to project teams and expert witnesses and, when necessary, testify on data-driven analyses.
• Apply attention to detail, math-checking discipline, problem-solving, and sound judgment across multiple engagements.
• Communicate complex analyses clearly and work effectively with consultants, attorneys, expert witnesses, clinical reviewers, and other specialists.
• Take ownership of work and demonstrate Stout's stated core values while delivering Relentless Excellence.

Benefits

• Comprehensive Total Rewards program with competitive compensation, benefits, and wellness options.
• Professional growth support through ongoing training, mentorship, employee resource groups, and clear performance feedback.
• Flexible work schedules.
• Discretionary time off policy.
• Anticipated eligibility to participate in an annual bonus plan.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed