Position Details
About this role
Analyzes medical and pharmacy claims data to identify risks and support underwriting decisions, creating detailed reports and summaries for medical risk assessment.
Key Responsibilities
- Review claims data
- Analyze medical reports
- Prepare risk summaries
- Collaborate with underwriting
- Conduct data mining
Technical Overview
Utilizes claims data, ICD coding, ESL System, SQL, and data visualization tools to review and analyze large healthcare datasets for risk evaluation.
Ideal Candidate
The ideal candidate is a mid-level healthcare data analyst with experience reviewing medical and pharmacy claims data, proficient in ICD-10, CPT, and HCPCS coding, and skilled in data reporting and analysis tools.
Must-Have Skills
Nice-to-Have Skills
Tools & Platforms
Required Skills
Hard Skills
Soft Skills
Industry & Role
Keywords for Your Resume
Deal Breakers
Lack of experience with claims data analysis, No knowledge of ICD-10 or CPT codes, Inability to work remotely, No experience with ESL System
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