Key skills
Data MiningCommunicationCollaboration
About this role
Role Overview
- uses technology and data mining to detect anomalies in data to identify and collect overpayment of claims
- contributes to the investigations of fraud waste and our financial recovery
- contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment
- provides input into function strategy
Requirements
- Minimum 5 years of progressive people management experience
- Previous experience with healthcare operations
- Previous experience in the medical claims space
- Experience leading projects and processes
- Experienced facilitating, consulting, and delivering complex concepts
- Progressive experience in onshore/offshore contracting space for a health solutions industry
- Able to determine the needed approach, resources, and goals to meet business objectives
- Demonstrated experience with cross departmental collaboration
- Comprehensive knowledge of Microsoft Office Programs Word, PowerPoint, and Excel
- Ability to handle multiple priorities
- Capacity to maintain confidentiality
- Excellent communication skills both written and verbal
- Proficiency in analyzing and interpreting financial trends
- Strong collaboration skills
Benefits
- medical, dental and vision benefits
- 401(k) retirement savings plan
- time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
- short-term and long-term disability
- life insurance