Sagility

Consultant II Data Mining

Sagility(27 days ago)

RemoteFull TimeMedior$86,313 - $116,102 (estimated)Payment Integrity
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About this role

A Payment Integrity Data Mining Consultant II is a client-facing specialist who analyzes medical claim data to identify incorrect payments and develop new audit concepts. The role leverages industry experience and regulatory research to design pricing methodologies and enhance audit automation and systems. It focuses on generating high-quality recoverable claims and supporting validation and documentation of moderate to complex recovery projects.

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Required Skills

  • Rule Development
  • Business Analysis
  • Pricing
  • COB
  • Analytics
  • Rule Validation
  • Auditing
  • Payment Processing
  • Data Integration
  • Reporting

+7 more

Qualifications

  • High School Diploma
  • BA/BS Preferred
Sagility

About Sagility

sagilityhealth.com

Sagility delivers end-to-end healthcare BPO, revenue cycle management, and clinical support services for providers and payers. Explore our full-service model.

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