Data Mining Consultant

A company is looking for a Data Mining Consultant (Client Lead). Key Responsibilities Lead a team in identifying audit opportunities and enhancing systems automation Review payment-related data to ensure accuracy and compliance, while performing audits to identify discrepancies Participate in client meetings and manage team training and development Required Qualifications, Training, and Education 5+ years of experience in direct claim processing and reimbursement 3+ years of management experience in claims processing is preferred Experience in developing auditing rules and conducting business case analysis Knowledge of healthcare data synthesis and payment integrity reporting Prior experience in claims auditing or consulting in a healthcare environment is desirable

May 1, 2025 - 08:42

A company is looking for a Data Mining Consultant (Client Lead). Key Responsibilities Lead a team in identifying audit opportunities and enhancing systems automation Review payment-related data to ensure accuracy and compliance, while performing audits to identify discrepancies Participate in client meetings and manage team training and development Required Qualifications, Training, and Education 5+ years of experience in direct claim processing and reimbursement 3+ years of management experience in claims processing is preferred Experience in developing auditing rules and conducting business case analysis Knowledge of healthcare data synthesis and payment integrity reporting Prior experience in claims auditing or consulting in a healthcare environment is desirable