Description review
Senior Manager - Data Analyst for Medical Health Claims
EXL · United States · back to the listing
HR standards
51/100
needs work
Title ↔ description
59/100
needs work
Reads as
Data Analyst
98% confident
What this role officially is
data analyst — ESCO, the EU occupation classification
Data analysts import, inspect, clean, transform, validate, model, or interpret collections of data with regard to the business goals of the company. They ensure that the data sources and repositories provide consistent and reliable data. Data analysts use different algorithms and IT tools as demanded by the situation and the current data. They might prepare reports in the form of visualisations such as graphs, charts, and dashboards.
Also known as: data warehousing analyst, data analysts, data warehouse analyst, data storage analyst
How others title the same work
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Startups
- Senior Data Analyst Camber
- Senior Data Analyst Confido
What the listing never says
- No section describes what the person would actually do. Scope clarity
- No location or timezone policy stated, so a candidate cannot tell where they may work from. Scope clarity
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Nothing in the wording of this listing tripped a check. The scores above still judge how complete and coherent it is.
The Senior Manager Diagnosis Related Group (DRG) SME will support the business team in evaluating trends on utilization of products / services based on historical data - such as care management trends, claim utilization, member attributes, to develop cost effective quality product / services. The ideal candidate retrieves, organizes and performs research/analysis on Medical Health Claim data primarily to identify root cause and is a proactive thinker, self-starter, who enjoys working in a fast-paced and challenging environment with the ability to work independently. Candidate should have a strong understanding of both inpatient MS-DRG/APR-DRG payment systems and have experience/knowledge in health care claims. Additional experience with Outpatient, HH, SNF, BH, IRF, Professional, DME, HCD claims is a plus. Previous claims payment and auditing experience would also be beneficial and recommended. Understanding of Medical claim terminology and insurance terminology. Experience with payer policy, claim system limitations, provider contracting terms are highly recommended. Experience with Pre-Pay and Post-Pay code edit/rules development is recommended/encouraged as well.
Salary Range for this role is: $120k - $125k
For more information on benefits and what we offer please visit us at
Originally posted on Himalayas
Salary Range for this role is: $120k - $125k
For more information on benefits and what we offer please visit us at
Originally posted on Himalayas