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Job title

***Healthcare Claims Analyst with SQL Reporting MD US ***

Company Ajilon
Wage between $0.00 - $0.00 Annually
Location United States, Maryland, Baltimore
Employment type Full Time
Education Not Specified
Year Experience 4 - 5 Years of Practical Experience
Travel Not Specified
Published on 10/26/2009
Description
Ajilon Consulting is a premier provider of Information Technology business solutions, with clients spanning all industries. At Ajilon, we invest in our people with continuous training and education programs, along with competitive benefits and compensation. If you are an IT professional looking for exciting, new opportunities, look to Ajilon Consulting!

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.

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Experience/Skills
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!
 
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