Data Mining Ideation Specialist

United States - Remote R

USD 100K Mid-level Full Time

@ M...

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Found 21d ago

Tasks

Collaborate with audit analytics and operations teams to implement audit concepts
Define data selection requirements
Design data mining audits
Develop training materials for audit staff
Identify audit opportunities using contracts and regulations
Maintain medical coding and reimbursement expertise
Monitor audit performance and yield
Refine audit logic based on performance
Serve as data subject matter expert
Support production audit teams with guidance and quality initiatives
Validate audit outputs

Perks/Benefits

Skills/Tech-stack

APC | CPT | Claims Processing | Commercial Insurance | Coordination of Benefits | DRG | EAPG | EDI 835 | EDI 837 | Eligibility | Excel | HCPCS | ICD-10 | LCD | MUE | Medicaid | Medicare | NCCI edits | NCD | Payer Edit Development | Payment integrity | Ptp | Python | Reimbursement Methodologies | SQL

Education

N/A

Roles

Regions

North America

Countries

United States

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