Sr. Clinical Analyst

Position Overview:

•   The Senior Clinical Analyst role combines clinical data expertise with relationship management to ensure accurate claims processing, resolve billing discrepancies, and optimize carrier performance.

The analyst plays a key role in analyzing healthcare data to identify improper payments, communicate findings, and drive resolution through data-backed insights.  Responsibilities:

•   Possess a clear understanding of the identification and investigation of issues and billing activities leading to improper payments is required as this work involves reviewing medical claims data (professionals, facilities, insured members, or the broker community).  Review medical records and compare to claims data to review for billing accuracy and savings opportunities  Utilize information from claims data...