Discipline - Business Operations
Industry - Business Analysis
Job Description - Job Responsibilities
Analyse data related data to FWA allegation and come up with solutions (using available tools).
Create, analyse and maintain explanatory/predictive models of clinical behaviours using healthcare claim data.
Work includes all phases of the modelling process: research design, data extraction and cleaning, model building and validation.
To work through the entire life cycle of a project from inception to implementation.
To research on the new fraud & abuse patterns & generate new projects basis the research.
Co-ordinate with clinical/Coding SMEs for seeking the inputs to explore data extraction approach and road map the analysis mile stones.
Develop and maintain working relationships with key customer stakeholders
Qualification - Required Skill Set
Exp Range -3-8 years of work experience in the area(s) of advance statistical analysis/modelling/data mining/Machine Learning
Proficiency required in one or more of analytical tools such as SAS, R, Matlab.
Experience in at least two of the areas:
Statistical modeling (Regression, Classification, Time-series forecasting) /Machine Learning /Text Mining /Optimization /Visualization
Knowledge on Machine Learning Techniques- and Big Data Hadoop would be added advantage
Knowledge of statistical tools and techniques, especially those relating to data mining
Demonstrated ability to work with large data sets
2-4 years of work experience in the area of Fraud detection Analytics
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