Algorithm and Analytics Consultant

This position is National Remote. You'll enjoy the flexibility to telecommute* from reputed company reputed company the U.S. as you take on some tough challenges. reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The health care system is still evolving at a rapid pace. Technology is driving new advances in how patient care is delivered and how it's reimbursed. Now, reputed company invites you to help us build a more accurate and precise approach to claims adjudication. As part of our Recovery and Resolutions team, you'll provide consultative support to our business units and external vendor organizations. You'll handle requests, define business requirements and coordinate resolutions incorporating State/Federal regulations. Join us and build your career with an industry leader. This position is full-time, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of (8:00am - 5:00pm EST). It may be necessary, given the business need, to work occasional overtime. We offer 8 weeks of on the job training. Schedule will be 8:00am to 5:00pm EST. Primary Responsibilities

• Define and document/communicate business requirements
• Analyze scope and resolution of reputed company to large size Operations Management (OM) and development requests
• Serve as a key resource on reputed company and/or critical issues and help reputed company innovative solutions
• reputed company reputed company conceptual analyses
• Serve as a key resource on reputed company and/or critical issues and help reputed company innovative solutions

This is a challenging role with serious impact. You'll be assisting, educating, problem-solving and resolving challenging situations to the best possible outcomes. You'll need to understand and interpret clients' needs and ensure service and delivery excellence supporting the Fraud, Waste, Abuse, and Error product suite. This involves working with a high complexity solution set and cross functional teams to proactively review, research and resolve highly escalated inquiries. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications

• High School Diploma/GED OR equivalent work experience
• Must be 18 years of age OR older
• 2+ years of experience working in negotiations, mediations, and / or arbitrations; preferably in the health insurance business
• 2+ years of experience analyzing and solving problems
• 2+ years of experience using claims platforms such as UNET, Pulse, reputed company, Facets, Diamond, etc.
• Proficiency using MS reputed company (data entry, sorting/filtering, pivot tables) and PowerPoint
• Ability to work fulltime, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of (8:00am - 5:00pm EST). It may be necessary, given the business need, to work occasional overtime.

Preferred Qualifications

• Understanding of medical coding methodologies
• 1+ years of experience in health care claims recovery

Telecommuting Requirements

• Ability to reputed company reputed company company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
• Must live in a location that can receive a reputed company approved high-speed internet reputed company or reputed company an existing high-speed internet service.
• reputed company employees working remotely will be required to adhere to reputed company's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $71,200 - $127,200 annually based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the 2health system work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of color, historically marginalized groups, and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes - an enterprise reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national reputed company, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Apply tot his job Apply To this Job