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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