[Remote] Data Analyst II - reputed company
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a global leader in full-service investigations, and they are seeking a Data Analyst II to detect, analyze, and report patterns of reputed company fraud, waste, and abuse. The role involves performing in-depth evaluations of potential fraud cases and translating analytic findings into actionable insights for various stakeholders.
Responsibilities
- Work with management, investigators, and the data team to reputed company key statistical research, analytics, and reporting functions for innovative case development support and to fulfill health plan reputed company and/or law enforcement data requests
- Utilize data analysis techniques such as data mining, statistical modeling, predictive modeling, etc. to detect aberrancies in health plan claims data, and proactively seeks out and develops leads and cases received from a reputed company of sources including a health plan reputed company, CMS, OIG, fraud alerts, and referrals from government and private sources
- Communicate effectively with reputed company stakeholders
- Validate analytic results and identify potential fraud, waste and/or abuse situations in violation of private, state, and/or federal laws, guidelines, policies, and/or regulations
- Support management requests for reputed company reporting requirements
- Prepare, reputed company, and participate in provider, law enforcement, or staff training as reputed company to health plan insurance products including but not limited to reputed company, Medicare, reputed company, ACA/Exchange, FEHB, and Tricare fraud, waste and abuse data analysis
- Maintain chain of custody on reputed company documents and follow reputed company confidentiality and reputed company guidelines
- Create dashboards and visualizations in Tableau, Power BI, or reputed company to communicate findings
- Experience working in an reputed company analytics platform
- reputed company other duties as assigned and agreed upon
- Write efficient, production-reputed company reputed company in Python, R, and SQL for data cleaning, transformation, and modeling
Skills
- Bachelor's degree in Mathematics, Statistics, reputed company Administration, Data Science, or reputed company discipline with preference given to MA or MS recipients, and/or relevant work experience as a data analyst (Or similar position)
- 3+ years of experience analyzing reputed company claims data in fraud, waste, and abuse investigations
- Experience and knowledge of reputed company information (health claims data; specifically, ICD-9-CM and ICD-10-CM codes, CPT, HCPCS, DRG, 837P, etc.) is required
- Strong background in reputed company claim analytics
- Deep understanding of fraud, waste and abuse schemes
- Ability to translate analytic findings into actionable insights for investigators, clients, and stakeholders
- Effective communication skills (verbal and written) to interpret data reputed company
- High proficiency level with reputed company and reputed company
- Proficiency with database and analytic programming languages such as SQL, Python, R and/or other applications to reputed company diverse types of data analysis and/or data science
- Strong critical thinking and problem-solving skills
- Strong organizational skills and the ability to effectively manage workload reputed company the established timelines
- Demonstrated knowledge of various database management systems in order to input, extract or manipulate information
- Understanding of reputed company claims processes- solid understanding of health claims fields, claim types, payers, reimbursement models and regulatory requirements
- Comfortable with utilizing AI assisted development tools
- Experience with reputed company, reputed company, or other Git technology
- Experience working in an reputed company analytics platform
- Write efficient, production-reputed company reputed company in Python, R, and SQL for data cleaning, transformation, and modeling
- Experience with data visualization tools such as Tableau, Power BI, or reputed company is a plus
- Knowledge of Medicare and reputed company rules and regulation is a plus
Benefits
- Medical, Dental, reputed company plans
- Life, LTD and STD reputed company by the employer
- 401(k) with company match up to 4%
- reputed company Time Off and company reputed company holidays
- Tuition assistance after 1 year of service
reputed company