Job Summary
- Company
- Ajilon
- Location
- Baltimore, MD 21201
- Industries
- Other/Not Classified
- Job Type
- Full Time
- Employee
- Career Level
- Experienced (Non-Manager)
- Job Reference Code
- 14327.20913.ClaimsAnalyst
***Healthcare Claims Analyst with SQL Reporting MD US ***
About the Job
Job Description:
Ajilon Consulting is a global provider of IT solutions with 40 years of experience and offices throughout North America, Europe, and Australia. We support clients' immediate and long-term business needs by delivering a wide array of consultative IT services and by providing contingent consultants on an individual or group staffing basis. Our contingent consultants possess IT skills that supplement internal client resources during workload peaks, fill critical areas of expertise, and staff mission critical projects.
With our parent company Adecco, we have a wide presence in North America and globally with more than 6,600 offices in 70 countries worldwide. Together we employ more than 700,000 associates on-assignment supporting over 150,000 clients.
Job Description:
Position Summary:
The Claims Recovery Analyst will be responsible for the development of enterprise-wide business reports based on the specific needs of our internal/external clientele to support utilization, medical management, claims payment accuracy, and performance. This position requires a well developed understanding of the health insurance / health care industry, and in-depth understanding of health care data and the methods of data analysis.
General Responsibilities:
. Create ad hoc and standard reports using various reporting tools for different functional areas of the company.
. Assess reporting results through data investigation, analysis, and evaluation.
. Analyze data and trends and create documentation supporting all of the reports.
. Prepare written analysis and summarize results using graphical representations and professional formatting.
. Ensure that reports support the overall scope of company's business strategies.
. Maintain data integrity and ongoing quality control of delivered reports.
. Work closely with all levels of end users, including executive level staff, to quickly develop reports which will be used to make strategic business decisions.
. Create detailed documentation outlining report criteria and provide recommendations to the requestor based on the results of the report.
. Initiate new projects that benefit the goals of the company.
. Have advanced knowledge of utilization, claims processing procedures, claims payment guidelines and/or fraud, waste and abuse.
. QA reports for not only coding errors and issues, but also make suggestions on data representation
Required Education & Work Experience:
. Bachelor's degree in Computer Science or related field required
. Minimum 3 years experience as a Report Writer/Analyst
. Minimum 5 years progressive experience in Information Technology
. Experience in health plan, medical claims, and SQL required, FACETS preferred
Required Knowledge, Skills, and Abilities:
. Strong analytical and problem solving skills and abilities.
. Ability to interface with multiple users across the organization and effectively project manage reporting requirements from start to finish.
. Ability to work in a rapidly changing and growth oriented environment with regularly changing priorities and developing opportunities.
. Demonstrate strong communication (both verbal and written), and customer service skills, and exchange information with others clearly and concisely.
. Ability to manage own work flow and meet deadlines while responding to frequent demands of multiple customers (internal and external).
. Take ownership of each project from start to finish and follow-up with management on project status.
. Extensive professional experience in data analysis and report design/development.
. Extensive knowledge of reporting programs and tools.
. In-depth knowledge and experience with relational database concepts and query tools.
. Sound knowledge of SQL and data extraction methodologies.
. Strong report presentation skills.
. Excellent communication and interpersonal skills.
You can view all of our jobs online at http://www.ajilonconsulting.com .
Job Experience:
For immediate consideration, please submit your resume. Please list how many years you have experience in the required skill. Qualified candidates will be contacted for further discussion about this opportunity.
We are unable to offer sponsorship. Preference will be given to local or commutable candidates.
Thank you for your interest in Ajilon Consulting!
This company may offer relocation assistance.
Ajilon Consulting is a global provider of IT solutions with 40 years of experience and offices throughout North America, Europe, and Australia. We support clients' immediate and long-term business needs by delivering a wide array of consultative IT services and by providing contingent consultants on an individual or group staffing basis. Our contingent consultants possess IT skills that supplement internal client resources during workload peaks, fill critical areas of expertise, and staff mission critical projects.
With our parent company Adecco, we have a wide presence in North America and globally with more than 6,600 offices in 70 countries worldwide. Together we employ more than 700,000 associates on-assignment supporting over 150,000 clients.
Job Description:
Position Summary:
The Claims Recovery Analyst will be responsible for the development of enterprise-wide business reports based on the specific needs of our internal/external clientele to support utilization, medical management, claims payment accuracy, and performance. This position requires a well developed understanding of the health insurance / health care industry, and in-depth understanding of health care data and the methods of data analysis.
General Responsibilities:
. Create ad hoc and standard reports using various reporting tools for different functional areas of the company.
. Assess reporting results through data investigation, analysis, and evaluation.
. Analyze data and trends and create documentation supporting all of the reports.
. Prepare written analysis and summarize results using graphical representations and professional formatting.
. Ensure that reports support the overall scope of company's business strategies.
. Maintain data integrity and ongoing quality control of delivered reports.
. Work closely with all levels of end users, including executive level staff, to quickly develop reports which will be used to make strategic business decisions.
. Create detailed documentation outlining report criteria and provide recommendations to the requestor based on the results of the report.
. Initiate new projects that benefit the goals of the company.
. Have advanced knowledge of utilization, claims processing procedures, claims payment guidelines and/or fraud, waste and abuse.
. QA reports for not only coding errors and issues, but also make suggestions on data representation
Required Education & Work Experience:
. Bachelor's degree in Computer Science or related field required
. Minimum 3 years experience as a Report Writer/Analyst
. Minimum 5 years progressive experience in Information Technology
. Experience in health plan, medical claims, and SQL required, FACETS preferred
Required Knowledge, Skills, and Abilities:
. Strong analytical and problem solving skills and abilities.
. Ability to interface with multiple users across the organization and effectively project manage reporting requirements from start to finish.
. Ability to work in a rapidly changing and growth oriented environment with regularly changing priorities and developing opportunities.
. Demonstrate strong communication (both verbal and written), and customer service skills, and exchange information with others clearly and concisely.
. Ability to manage own work flow and meet deadlines while responding to frequent demands of multiple customers (internal and external).
. Take ownership of each project from start to finish and follow-up with management on project status.
. Extensive professional experience in data analysis and report design/development.
. Extensive knowledge of reporting programs and tools.
. In-depth knowledge and experience with relational database concepts and query tools.
. Sound knowledge of SQL and data extraction methodologies.
. Strong report presentation skills.
. Excellent communication and interpersonal skills.
You can view all of our jobs online at http://www.ajilonconsulting.com .
Job Experience:
For immediate consideration, please submit your resume. Please list how many years you have experience in the required skill. Qualified candidates will be contacted for further discussion about this opportunity.
We are unable to offer sponsorship. Preference will be given to local or commutable candidates.
Thank you for your interest in Ajilon Consulting!
This company may offer relocation assistance.
Company Tools
Contact Information
Recruiting Department
Ajilon
901 Dulaney Valley Rd. Suite 309
Towson, MD 21204
Fax: (410) 321-7918
