Data Analyst - Claims & Cost Containment
Tasks
- Analyze medical claims data
- Benchmark performance against market standards
- Collaborate with underwriting product and analytics teams
- Conduct pharmacy review
- Develop trigger based rules for member interventions
- Evaluate cost containment program effectiveness
- Identify trends anomalies high cost drivers
- Initiate member outreach and case management
- Investigate fraudulent claims patterns
- Recommend cost containment optimizations
- Refine dashboards models and monitoring tools
- Review stop loss claims
- Uncover actionable claims insights
Perks/Benefits
- Covered health insurance
- Dental insurance
- Equity
- In-office meals
- Life insurance
- Remote work setup stipend
- Vision insurance
Skills/Tech-stack
Abuse detection | CPTHCPCS | Claims Adjudication | Claims Analysis | Cost containment | DRG | Data Analysis | Excel | Fraud Detection | Healthcare Data | ICD10 | Loss Claims | Python | SQL | Stop Loss Claims | Stop-loss | Waste And Abuse Detection
Education
Roles
Regions
Countries
States
Cities
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