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SmartLight Analytics

Harness the power of your healthcare data

Pharmacy Payment Integrity Analyst

AnalystAnalystOtherRemoteSeniorTeam 1-10Since 2016H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

176 days ago

Salary

0

Seniority

Senior

Bachelor Degree4 yrs expExperience acceptedEnglish

Job Description

Pharmacy Payment Integrity Analyst

SmartLight Analytics

• Identify and investigate healthcare billing activities leading to improper payments • Review claims data and conduct analysis to look for patterns of potential improper payments • Conduct data analysis to review claim and case history • Review claims history, medical reviews, provider files, etc. • Identify and resolve issues related to data discrepancies, missing data, or inconsistencies within clinical datasets

Job Requirements

  • Bachelor's degree or 4 – 6 years of equivalent work experience in healthcare administration, billing, claims adjudication, clinical auditing, payment integrity operations and/or healthcare reimbursement
  • CPC, CCS or other relevant clinical/coding certifications strongly preferred
  • Strong knowledge of clinical terminology, medical procedures, and healthcare workflows
  • Detail-oriented with excellent communication skills (oral presentations and written) and interpersonal skills
  • Strong critical-thinking, communication and attention to detail skills

Benefits

  • Health insurance
  • Retirement plans
  • Paid time off

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