Healthcare Claims and Data Analyst

$68,000 - $68,000/Yr

Nevada Behavioral Health Systems - Las Vegas, NV

Full-time - Mid Level

Onsite - Las Vegas, NV

Ambulatory Health Care Services

About the position

The Healthcare Claims and Data Analyst at NovumHealth plays a vital role in the accurate processing of healthcare claims and the analysis of claims data. This position is essential for ensuring compliance, operational efficiency, and data-driven decision-making within the organization. The ideal candidate will leverage their healthcare industry knowledge and technical skills to interpret and analyze claims data effectively.

Responsibilities

• Conduct thorough reviews of healthcare claims to ensure accuracy and compliance with payer regulations.
• Analyze claims data to identify trends, outliers, or discrepancies that may indicate billing errors or potential fraud.
• Prepare detailed reports and dashboards to present key insights to leadership.
• Collaborate with cross-functional teams to streamline the claims review process and ensure data integrity.
• Generate reports and analyze claims data to identify trends, patterns, and opportunities for process improvement.
• Conduct audits of claims processes and documentation to ensure compliance with regulatory requirements and internal policies.
• Develop and maintain databases or systems to store and manage claims data effectively.
• Participate in meetings to provide insights and recommendations based on claims data analysis.
• Assist in developing predictive models for claims forecasting and identifying areas of cost containment.
• Assist in the development and implementation of strategies to enhance claims processing efficiency and accuracy.
• Stay updated on industry changes, regulations, and best practices related to claims processing and data analysis.

Requirements

• A minimum of 2 years of experience in healthcare claims analysis, medical billing, or healthcare data analysis.
• Familiarity with the healthcare claims cycle, including submission, denial management, and compliance with payor guidelines.
• Bachelor's degree in healthcare administration, business, data analysis, or a related field (or equivalent combination of education and experience).
• Certification in claims analysis or data analysis (e.g., Certified Professional in Healthcare Quality) is preferred.
• 3 years of experience with Microsoft Excel.

Benefits

• Full-time position with a starting salary of $68,000 per year.