Pune, India
Information Technology
Full-Time
Ceiyone
Overview
Experience: 3-5 Years
Location: Remote
Core Role: Healthcare Data Analyst
Primary Responsibilities:
- Analyze healthcare claims, eligibility, and provider data to extract insights.
- Write and optimize SQL queries to join large datasets and investigate issues.
- Perform root cause analysis for data anomalies and claims processing issues.
- Support data mapping and normalization to align with an enterprise data warehouse model.
- Collaborate with stakeholders to define data needs and solve healthcare-specific problems (e.g., quality scores, compliance).
- Understand and analyze the full revenue cycle management (RCM) process.
- Identify denial patterns, automate repetitive processes, and suggest improvements.
- Work with clinical and financial stakeholders to ensure accurate coding and claims processing.
- Maintain compliance with Medicaid, Medicare, and other payer regulations.
Supplementary Role 1: Revenue Cycle Analyst
Primary Responsibilities:
- Understand the full RCM process and help identify and rectify issues.
- Analyze and track revenue cycle trends, proposing optimization methods.
- Collaborate with finance teams to improve coding and claims management.
- Identify and resolve issues related to denials and claims processing delays.
- Ensure regulatory compliance, including adherence to Medicaid and Medicare rules.
Supplementary Role 2: Business Analyst
Primary Responsibilities:
- Gather and document business requirements from stakeholders.
- Translate high-level business needs into detailed user stories and functional requirements.
- Work with Agile teams to plan sprints, prioritize backlog items, and ensure successful implementation.
- Conduct impact assessments for changes to systems and workflows.
- Bridge the gap between business teams and development teams to ensure solutions align with organizational goals.
Supplementary Role 3: Data Mapper
Primary Responsibilities:
- Map disparate healthcare data sources (claims, eligibility, provider, and clinical data) to a standardized model.
- Ensure accurate data integration by understanding data structures, field relationships, and attributes.
- Collaborate with developers to implement mappings and resolve data integration issues.
- Validate and test mapped data to ensure consistency across systems.
Supplementary Role 4: Product Manager (Data Solutions)
Primary Responsibilities:
- Define the vision and roadmap for data warehouse and analytics solutions.
- Collaborate with technical and non-technical stakeholders to prioritize business needs.
- Evaluate return on investment (ROI) for data initiatives and drive strategic decisions.
Experience:
- Prior experience working as a Revenue Cycle Analyst in the Healthcare system.
- Must have a working knowledge of relational databases/database structures, SQL experience desired.
- Must have a strong understanding of data collected and used in EMRs, Revenue Cycle, and Patient Accounting Systems.
- Knowledge and experience with ambulatory and acute clinical, billing, and claims workflows and clinical information systems.
- Bachelor’s or Master’s degree in related health or finance field (e.g., informatics, bioinformatics).
- Ability to work in a stressful environment and with minimal supervision.
Send your resumes to: career@ceiyone.com; saranya.ravikumar@ceiyone.com
Note: Please include the role in the subject line of the email.
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