Sr Data Analyst

Senior RCM Policy Data Analyst

Locate, validate, and analyze data utilizing tools such as SAS, SQL, Access, VBA and Tableau, from disparate sources to support RCM goals and RCM leadership requests. Combine specimen data from all systems in the RCM life cycle (lab and billing), claim transactions, and data elements provided in policies from payers and government entities to influence and initiate changes in claim outcomes, payer behavior, or system processing. Reduce risk of lost revenue to company through Systems Control support research, monitoring of system functions through alert modeling, and business rule development of system changes.

Major Duties & Responsibilities:

• Develop large scale research level analysis, containing elements of
o Claim level data from billing or lab system in current state or following claim life cycle from order to post adjudication activity
 Noting recognition of system opportunities
o Industry standard transactions to and from payer
o Payer policy information applied to claim detail and system data
o Problem solving through applied cleverness and curiosity
• Work effectively with data and consistently validate the data and the results
o Able to use tools such as SAS, SQL, Access, Excel, VBA, Tableau
o Use statistical sampling and modeling to drive guidance
o Present analysis findings as a story that:
 Drive change in other business units
 Consistently alert business of deviations from the normal process
 Predict where research or change should be focused next
• Follow, and suggest changes to, business rule development for system technology changes using knowledge of system flow, policy guides, and claim examples
• Participate in team and RCM Policy discussions as active participant or facilitator
o Share own work and share ideas on other team efforts
o Support team development with sharing of data analysis concepts and techniques
• Support industry activities of RCM Policy under industry workgroups, acquisitions, and payer meetings with research or process testing
o Use methods of data collection from industry standard sources to develop analyses that support Business Solutions team member efforts at industry level

Requirements:
Bachelors in Statistics, Mathematics, Informatics, Computer Science, Information Systems, or other like field required; Masters preferred and/or normally 5 – 10 year’s experience in data analytics preferred.

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