Data Analyst - Senior Manager in Medical Health Claims

EXL Talent Acquisition Team

76d

About The Position

The Senior Data Analyst will support the business team in evaluating trends on utilization of products/services based on historical data - such as care management trends, claim utilization, member attributes, to develop cost effective quality product/services. The ideal candidate retrieves, organizes and performs research/analysis on Medical Health Claim data primarily to identify root cause and is a proactive thinker, self-starter, who enjoys working in a fast-paced and challenging environment with the ability to work independently.

Requirements

• Experience and knowledge in health care claims including Inpatient, Outpatient, SNF, Rehab, Professional, DME, HCD/HIT areas.
• Understanding of Medical claim terminology and insurance terminology.
• Experience with provider billing practices and claim system limitations.
• Knowledge of provider contracting terms.
• Experience in Pre Pay and Post Pay processes.

Nice To Haves

• Previous claim payment experience.

Responsibilities

• Support the business team in evaluating trends on utilization of products/services based on historical data.
• Retrieve, organize, and perform research/analysis on Medical Health Claim data.
• Identify root causes of trends in care management and claim utilization.
• Develop cost-effective quality products/services.

What This Job Offers

• Career Level: Senior
• Number of Employees: 5,001-10,000 employees