Reporting Analyst - Payment Integrity
Job Code : GEN/1198
Work@HomeJob Description
Job role and key
responsibilities |
This role
is to build and implement an effective end to end reporting for payment
integrity which involves MIS reporting, BI reporting and dashboards for both
internal and client. The position is responsible for data collation, data
analytics, data reporting and utilizing some of the advanced BI tools.
Key Responsibilities: ·
Demonstrated
exceptional active listening and communications skills ·
Works with
internal and external department customers to define and document
requirements to enrich reporting capabilities ·
Develops
systematic reporting processes and procedures to ensure timely delivery of
daily, weekly, monthly, annual and ad hoc reporting to management and
clinical partners ·
Troubleshoots
data integrity issues, analyzes data for completeness to meet business goals
and trending ·
Produces
dynamic analytic summaries and visualizations that convey complex analytic
problems and solutions in a way that is accessible to non-technical customers ·
Serves as a
resource to operational claims and clinical staff, answering questions and
assisting with department informatics, reporting and trending, and
workflow/operational issues ·
Escalates
issues to department leadership for support and guidance ·
Assists in
the development and testing of new reports and ongoing support of existing
solutions, including defect identification and resolution ·
Collaborates
with leadership to identify highest value analytics projects that support
strategic business goals. ·
Develops
project timelines, communicates with customers, and cascades top priority
projects to team members to meet project deliverables and customer
expectations |
Required skills and qualification |
Qualification ·
Bachelor?s
degree in Computer Science, Statistics, Mathematics or related field
Required
Skills and Experience: ·
1-3 years of experience in collecting,
analyzing, and presenting US Healthcare data and recommendations to
management ·
Development
of end to end payment Integrity reports like Data Intake, Audit Selections,
Findings, Appeals, Medical record Management, Audit Operations, Recovery
Operations, Provider Correspondence and Forecasting & Invoicing ·
Experience
working within a health plan, managed care organization, provider operated
healthcare environment or third party administrator ·
Experience
in SAS, Power BI, Tableau, Qlikview ·
Extensive
knowledge of MS Office and related software applications, such as Word,
PowerPoint, Excel, Project ·
Load and synthesize healthcare data from
multiple sources ·
Implement and develop data concepts and
monitor their impact ·
Design, program and standardize processes
and reports ·
Familiar
with program or payment integrity initiatives, especially claims data and
supporting data, analytics and documentation around claims administration and
adjudication
An ideal candidate should be: ·
Keep abreast
of industry trends and opportunities and apply best practice to payment
integrity ·
Ability to
think analytically, apply analytical techniques and to provide in-depth
analysis ·
Love
collaborative environments that use agile methodologies to encourage creative
design thinking and find innovative ways to develop with cutting edge
technologies ·
Proven
interpersonal skills while contributing to team effort by accomplishing
related results as needed ·
Must be a
team player and adaptable to a dynamic work environment
|