Medical Economics Analyst - Remote

Presbyterian; Albuquerque (NM); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading healthcare organization is seeking a Data Analyst to analyze medical data and contribute to payment integrity processes. Candidates should have a Bachelor's degree in a related field and at least four years of experience in the healthcare industry. Proficiency in coding and advanced Excel skills are critical. The position offers remote work options and a comprehensive benefits package.

Benefits

Comprehensive benefits package

Opportunities for professional development

Employee Wellness Rewards Program

Qualifications

• 4+ years of experience in the healthcare industry.
• Proficiency in claim procedure coding (CPT/HCPCS, ICD, DRG).
• Experience with financial impact quantifications.

Responsibilities

• Analyze medical data to report savings.
• Collaborate with the Payment Integrity team.
• Develop reporting processes for medical claims.

Skills

Medical data analysis

Claim procedure coding

Advanced MS Excel skills

Strong communication skills

Education

Bachelor's degree in healthcare, accounting, finance, or related fields

Master's degree preferred

Tools

Oracle SQL

Tableau

SAS Enterprise Guide

Job description

Employer Industry: Healthcare Services

What to Expect

• Analyze medical data to report savings related to payment integrity processes and cost-reduction initiatives
• Collaborate with the Payment Integrity team to validate savings and address discrepancies with vendor invoices
• Develop and implement processes for reporting and reconciliation of medical claims
• Utilize various data sets and modeling approaches for financial impact quantifications and projections
• Support the development of reports as needed for internal teams and stakeholders

What is Required (Qualifications)

• Bachelor’s degree in healthcare, accounting, finance, or related quantitative fields; Master’s degree preferred
• Four years of experience in the healthcare industry, specifically in medical economics and product performance analysis
• Proficiency in claim procedure coding (CPT/HCPCS, ICD, DRG) and claim provider coding
• Advanced skills in MS Excel, Access, PowerPoint, Oracle SQL, and Business Objects
• Strong written and oral communication skills

How to Stand Out (Preferred Qualifications)

• Completion of two or more Society of Actuaries (SOA) exams
• Experience with Tableau, SAS Enterprise Guide, and VBA programming
• Knowledge of risk share arrangements and provider/vendor contracting analysis

Benefits and Environment

• Salary up to $56.92 per hour
• Comprehensive benefits package including medical, dental, vision, and life insurance
• Opportunities for professional development and engagement in health-enhancing activities through the Employee Wellness Rewards Program
• Work remotely from anywhere in the United States, with some state restrictions
• Chance to contribute to community health initiatives in New Mexico as part of a mission-driven organization

#HealthcareServices #MedicalEconomics #RemoteWork #CareerGrowth #EmployeeBenefits

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