Senior Data Mining AuditorVirtualVocations • Springfield, Missouri, United States
Senior Data Mining Auditor
VirtualVocations • Springfield, Missouri, United States
[job_card.variable_days_ago]
[job_preview.job_type]
- [job_card.full_time]
[job_card.job_description]
A company is looking for a Senior Data Mining Auditor to identify medical cost savings for healthcare insurance clients through data mining strategies.
Key Responsibilities
Support the Payment Integrity team with operational reports and dashboards development
Produce detailed data mining reports and extract critical information from data sets
Develop quality control processes and create algorithms to flag suspect claims
Required Qualifications
Seven years of medical claims investigation or data mining experience, with five years in a leadership role
Relevant medical billing and coding certification and a bachelor's degree are highly preferred
Minimum high school diploma or GED
Experience with MS SQL Server, Power BI, and medical claim reimbursement structures
Proficiency in medical terminology and familiarity with healthcare regulations
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