Job Summary
A company is looking for a Data Analyst II to conduct evaluations and analyses of potential fraud cases using healthcare claims data.
Key Responsibilities
- Perform comprehensive analysis of healthcare claims data and prepare structured reports summarizing findings
- Collaborate with various stakeholders to support case development efforts and fulfill data requests
- Apply data mining and statistical modeling techniques to identify anomalies in claims and generate leads for investigations
Required Qualifications
- Bachelor's or Master's degree in Mathematics, Statistics, Health Informatics, Data Science, or a related field
- Minimum 2 years' experience analyzing Medicare and/or Medicaid data
- Minimum 2 years' experience in SQL and Python
- Working knowledge of SAS, Databricks, Snowflake, or Spark
- Strong understanding of healthcare claims and Medicare/Medicaid billing practices
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