Dear Partner,


Hope you are doing great!



Please find below the urgent requirement and let me know if you have any
available consultant for the same.

Please share resume at *atu...@directionstaff.com
<atu...@directionstaff.com>*



*Data Analyst (Claims)*

*Location: Franklin, TN*

*Duration: 12+ Months*



*Mandatory Skills:*



Ø  Ability to look at adjudicated claims / membership / eligibility files
and :

ü  Different types of claims: Medicare, Medicaid, Commercial, Professional,
Institutional, etc.

ü  Identify issues with the claims / eligibility data

ü  Identify solutions to fix data issues

ü  Use benchmark and supply missing data to facilitate client analytics



Ø  *Ability to work closely and communicate with client team analysts to: *

ü  Report issues with the data

ü  Request for missing data from end client

ü  Share data analysis findings in a structured manner

ü  Confirm approach to fix data issues in the claims / eligibility files



Ø  *Ability to work closely and communicate with SQL Developer(s) to: *

ü  Ability to write SQL queries to identify data issues independently
(Microsoft SQL Server)

ü  Ability to analyze business rules, perform data mapping and guide SQL
developers to create ETL processes.



Ø  *Has experience working with: *

ü  Data editing tools (e.g. VEDIT, NOTEPAD++)

ü  Data profiling / analyzing tools (e.g. SQL Profiler, DQ Analyzer etc)

ü  SQL queries and databases

ü  Different Crosswalk tables (used in the health insurance domain)



Ø  Knowledge of automated utilization review, specialty benefit management
and data analysis systems

Ø  Excellent verbal and written communication skills and the ability to
interact professionally with a diverse group, executives, managers, and
subject matter experts



*Desired Skills:*

   - Proficient with MS Office, including Visio
   - Ability to understand SQL stored procedures, SAS code



*Job Responsibilities:*

   - Understands claims process and is able to interpret the information in
   a claim file
   - Work with Client Analytics teams  and elicit requirements using
   document analysis, requirements workshops, surveys, and business process
   descriptions
   - Proactively communicate and collaborate with external and internal
   customers to analyze data needs, as required

·         Serve as a Subject Matter Expert in Claims Eligibility and
validation processes

-- 

   -

   Thanks & Regards,

   *ATUL MALVIYA*

   *DirectionStaff Inc.*

   *atu...@directionstaff.com <atu...@directionstaff.com>*
   Gmail Id : atuld...@gmail.com
   YMail Id :  *recruiter.atul@yahoo. <recruiter.a...@yahoo.com>in *
   www.linkedin.com/pub/atul-malviya/90/327/79b/

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