Zelis is looking to analyze and manage healthcare claim data related to various reimbursement methodologies to support accurate claim processing, provide insights into contract performance, and contribute to process improvements.
Requirements
- Minimum of 2+ years of experience in healthcare data analysis
- At least 1+ years of experience with claim reimbursement methodologies such as Medicare, Medicaid, and Commercial
- Proficiency in SQL, including SELECT statements, JOINS, CTEs, and Subqueries
- Strong expertise in Microsoft Excel for data manipulation and reporting
- Experience with data visualization tools like Tableau is a plus
- Strong analytical and problem-solving skills
- Detail-oriented with excellent organizational skills
Responsibilities
- Analyze healthcare claim data to support decision-making and optimize reimbursement processes
- Interpret and interact with data stored in SQL databases to extract relevant insights
- Utilize Excel for data analysis, creating reports, and developing dashboards
- Understand and apply claim payment methodologies, including Medicare, Medicaid, and Commercial Reimbursements
- Create visualizations and dashboards to communicate data findings effectively (Tableau experience is a plus)
- Ensure compliance with privacy standards and internal policies regarding data security
- Identify opportunities for process improvements and system enhancements based on data insights
Other
- Excellent communication and collaboration skills
- Ability to manage multiple projects and prioritize effectively
- Self-motivated with a proactive approach to work
- Communicate complex data insights clearly and effectively to both technical and non-technical stakeholders
- Ability to think strategically and act tactically to achieve goals
