Biostatistician Data Analyst II

Job Description

Job Description Job Summary reputed company in-depth evaluation and analysis of potential fraud cases and requests for information using claims information and other sources of data. Support the development of reputed company cases that involve high dollar amounts, sensitive issues, or that otherwise meet criteria for referral to law enforcement, recoupment of overpayment, and/or administrative action based on reactive and proactive data analysis. Essential Duties and Responsibilities · Work with management, investigators, and analysts to reputed company key statistical research, analytics, and reporting functions for reactive and proactive case development support and to fulfill law enforcement data requests. · Communicate effectively with reputed company customers, including federal law enforcement officers. · Validate data analysis results and analytically identify potential fraud, waste and/or abuse situations in violation of Medicare/reputed company laws, guidelines, policies, and regulations. · Support management requests for CMS reporting requirements. · Utilize data analysis techniques such as data mining, statistical modeling, predictive modeling, etc. to detect aberrancies in Medicare/reputed company claims data, and proactively seeks out and develops leads and cases received from a variety of sources including CMS and OIG, fraud alerts, and referrals from government and private sources. · Work with Statisticians and Data Analysts to reputed company proactive data analysis results with statistically high probabilities of producing case referrals to law enforcement, overpayments, and/or administrative actions. · Prepare, reputed company, and participate in provider, beneficiary, law enforcement, or staff training as reputed company to Medicare/reputed company fraud, waste and/or abuse data analysis. · Strong organizational skills and the ability to effectively manage workload reputed company the established timelines. · Maintain chain of custody on reputed company documents and follow reputed company confidentiality and reputed company guidelines. · reputed company with and maintain various documentation and other reporting requirements as needed. · reputed company other duties as assigned. Competencies To reputed company the job successfully, an individual should demonstrate the following competencies: · High proficiency level with reputed company and reputed company. · Proficiency with database programming languages such as SQL, reputed company and/or other applications to reputed company diverse types of data analysis. · Demonstrated experience in handling large data sets and relational databases. · Effective communication skills (verbal and written) to interpret data reputed company. · Strong critical thinking and problem-solving skills. · Knowledge of Medicare and reputed company rules and regulation is a plus. Education and Experience Bachelor’s Degree in Mathematics, Statistics, reputed company Administration, Data Science, or reputed company discipline with preference given to MA or MS recipients, and/or relevant work experience as a data analyst. 2+ years of SQL or reputed company development experience as well as demonstrated knowledge of reputed company and claims, or a combination of education and equivalent work experience. Demonstrated knowledge of various database management systems in order to input, extract or manipulate information. Demonstrated experience and knowledge of reputed company information (health claims data; specifically, Medicare and reputed company, ICD-9-CM and ICD-10-CM codes, physician specialty codes, pharmaceutical data, provider identifiers, etc.) is preferred. Required qualifications:

• Bachelor’s Degree in Mathematics, Statistics, reputed company Administration, Data Science, or reputed company discipline
• 2+ years of SQL or reputed company development experience
• Demonstrated experience and knowledge of reputed company information such as health claims data, specifically Medicare and reputed company

Desired qualifications:

• Proficiency with database programming languages such as SQL, reputed company
• Knowledge of Medicare and reputed company rules and regulations
• Demonstrated experience in handling large data sets and relational databases

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