Transguard Workforce Solutions is the UAE’s leading provider of unique and innovative HR solutions. With a decade of experience in the region and a team that possesses extensive knowledge of the market, we provide a fully integrated HR solution.
We are currently recruiting for a Senior Officer - Data Analyst for one of our Insurance client to be based out of their Abu Dhabi office.
Job Purpose:
A Data Analyst in a medical audit team plays a crucial role in analysing and interpreting healthcare data to ensure compliance with regulatory standards, improve processes, and enhance overall efficiency in medical practices.
The job description may include the following responsibilities and qualifications:
Data Collection and Validation:
- Collect and validate medical data from various sources, including electronic health records (EHR), claims databases, and other relevant sources.
- Ensure the accuracy and completeness of data by performing thorough validation checks.
Data Analysis:
- Analyse medical and healthcare data to identify patterns, trends, and anomalies.
- Use statistical methods and data visualization tools to present findings and insights to the audit team.
Compliance Monitoring:
- Monitor and ensure compliance with medical coding standards, billing regulations, and other relevant healthcare policies.
- Identify and investigate discrepancies or potential issues related to coding and billing practices.
Performance Evaluation:
- Evaluate the performance of healthcare providers and medical facilities based on predefined metrics and benchmarks.
- Provide recommendations for improvement based on data analysis and findings.
Report Generation:
- Generate regular reports summarizing audit findings, compliance status, and performance metrics.
- Communicate results to the audit team, management, and relevant stakeholders.
Collaboration:
- Collaborate with other members of the medical audit team, including auditors, compliance officers, and healthcare professionals, to achieve common goals.
- Work closely with IT teams to ensure data integrity and security.
Continuous Improvement:
- Identify opportunities for process improvement and contribute to the development and implementation of best practices.
- Stay informed about changes in healthcare regulations and coding standards.
Qualifications:
Educational Background:
- Bachelors or Master's degree in a relevant field such as Health Informatics, Statistics, Data Science, or a related discipline.
Analytical Skills:
- Strong analytical and problem-solving skills with the ability to interpret complex healthcare data.
Technical Proficiency:
- Proficiency in data analysis tools and programming languages (e.g., SQL, Python, R).
- Familiarity with data visualization tools (e.g., Tableau, Power BI) is a plus.
Healthcare Knowledge:
- Understanding of medical coding systems (e.g., ICD-10, CPT) and healthcare regulations.
- Knowledge of healthcare operations and terminology.
Communication Skills:
- Effective communication skills to convey complex findings to both technical and non-technical stakeholders.
Attention to Detail:
- Strong attention to detail to ensure the accuracy and reliability of audit results.
Team Player:
- Ability to work collaboratively in a team-oriented environment.
Ethical Conduct:
- Adherence to ethical standards and maintaining confidentiality of sensitive healthcare information.
A Data Analyst in a medical audit team plays a crucial role in ensuring the quality, compliance, and efficiency of healthcare practices through data analysis and interpretation.