Discipline - Business Operations
Industry - Business Analysis
Job Description :
- Build Mathematical Rules & Models (algorithms) to capture Aberrant billing patterns by a team of certified coders, statistical analysts & SAS programmers working together for fraud & abuse detection.
- Team builds models through advanced statistical techniques of multivariate analytics with basic germane of US healthcare claims expertise
Job Responsibilities :
- Analyzing allegation related data to come up with solutions (using available tools).
- Create, analyse and maintain explanatory/predictive models of clinical behaviors 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.
- Coordinate 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
No. of Openings : 1
Qualification :
Mandatory Skill Set :
- Knowledge of statistical tools and techniques, especially those relating to data mining
- 3 to 5 years of work experience in the area(s) of statistical analysis/modelling/data mining
- Demonstrated ability to work with large data sets
- 3 to 5 years of work experience in the area of analytics/data analysis
- Experience in SAS 1 to 2 years
- Excellent MS office skills(MS Word, MS Excel)
Preferred Knowledge :
- Knowledge of US Healthcare
- R,- Tableau, Clementine, VBA -Optional
- Programming ability
Educational Qualification : Masters in Statistics/Maths/Econometrics
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