A healthcare company is searching for a person to fill their position for a Telecommute Payment Integrity Concept Researcher. Must be able to: Research and develop potential claim overpayment hypotheses Use data mining tools (i.e. SQL, Access, Excel) Run initial PL SQL queries to ensure hypothesis is worth developing further Qualifications Include: 2+ years of experience in healthcare (billing, coding, auditing claims) 2+ years of medical claims 2+ years of data analysis experience 2+ years of experience with claims processing or adjudication systems Maintaining working knowledge of coding standards, billing rules and regulations Knowledge of health plan and payment methodology
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