Assistant Manager - Datamining

Job Description: Communication Skill:

Strong written (documentation) and oral communication skills

Working Hours:

Full-time role (40 hours/week).

Shift: 08:00 AM – 05:00 PM IST (subject to change based on project requirements).

Weekends: Off (may vary based on business needs).

Telecommuter/Internet requirements, if applicable:

High Speed internet connection at home must be broadband.

Must understand and adhere with telecommuter policy.

Responsibilities: Skills and abilities:

• Should have a good understanding of the US healthcare system and management.

• Should have thorough understanding of healthcare payer analytics specifically the business model for datamining operations.

• Preferably candidates should have work experience in the data mining line of business.

• Should have thorough understanding contract audits, duplicates, reimbursement policies

• Will be responsible to audit claims on Medicare or Commercial business based various data mining concept.

• The position is purely metrics and target driven in the perspective of claim audits to initiate overpayment that exist in deployed data mining concepts.

• The position will be strictly evaluated based on the accuracy over claim audits and overpayments identification

• Should possess a strong interpersonal skill set to be able to work well with other people/teams, including in teams or groups, formally and informally.

• Should be able to work independently with minimal guidance.

• Should be purely data and metrics driven person and discuss with Manager on a regular basis on the program/individual.

Qualifications: Experience:

Claims Adjudication experience: Minimum 6 years

Overpayment experience.

Prefer candidates with experience in Post adjudication/overpayment projects.

Qualification:

Graduation is mandatory.