Company

Praesum Healthcare

Job #

P.4630

Job Type

Full Time

Job Description

Praesum Healthcare:
Position Title: Data and Claims Analyst

Founded in 2003, Praesum Healthcare provides administrative services for healthcare providers in key geographical locations throughout the Northeast, mid-Atlantic, and Southeast regions. Praesum is an established leader in the healthcare industry. With a solid, growth-focused business model, strong finances, and expert management team, Praesum will continue to grow in the years to come. Praesum currently provides services to behavioral health facilities providing all levels of care from inpatient psychiatric and substance abuse detoxification, through SUD and mental health outpatient clinics.

As a Data and Claims Analyst, the candidate will be reporting directly to the CEO and COO. The ideal applicant with a preferred marketing experience with high growth healthcare companies. the job candidate will be responsible for collecting, organizing and analyzing data to help implement marketing strategies and tactics. The primary focus will be to understand client’s behavior, identifying trends and patterns in data that can be used to optimize marketing campaigns and drive business growth.

Job Responsibilities:
• Collect and organize healthcare data from various sources, including medical records, market research surveys, customer databases, and web analytics tools.
• Analyze data using statistical techniques and software, such as Tableau, ArcGIS, Matplotlib, Klipfolio, and Google Data Studio.
• Collaborate with C-suite executives to identify KPIs and establish benchmarks for measuring campaign effectiveness.
• Identify opportunities for optimization and make recommendations for improving market performance, brand exposure, and revenue generation.
• Review and audit medical records for accuracy in billing, coding, and insurance requirements.
• Prepare billing forms and claims to be submitted electronically to clearinghouse and insurance carriers.
• Follow up with insurance carriers regarding accounts receivable and claim denials.
• Utilize CPT, HCPCS, and ICD-10 code sets for appropriate billing to insurance carriers.
• Release information to persons and agencies according to state and federal regulations.
• Possess the ability to critically analyze documentation and assign proper codes.

To be successful in this role the candidate should have:
• Strong analytical skills and be comfortable working with large datasets and software.
• Experience with different data visualization tools is a plus such as the following:
• Tableau, ArcGIS, Matplotlib, Klipfolio, Google Data Studio
• Strong communication skills and confidence to effectively present findings to the executive/leadership team
• Ability to make recommendations to both technical and non-technical audiences.

Job Requirements:
• Bachelor's degree in healthcare management, data analytics, or a related field.
• 3-5 years of experience in healthcare data analysis and 2 years of experience in claims processing.
• Working knowledge of Microsoft Office applications and data visualization tools.
• Strong analytical and communication skills with the ability to present findings to both technical and non-technical audiences.

Schedule:
• Full Time 8:30 AM - 5:00 PM; Monday - Friday.

Full time employees may be eligible for the following:
• Insurance: Medical, Dental, Vision, and STD options
• Medical FSA and Dependent Care Account
• 401k with company match up to 2.5%
• Accrued PTO Plan
• Education reimbursement
• Career Advancement Opportunities

*** This job does NOT sponsor visa's and we are unable to consider out of country applicants ***

If you are interested in this opportunity or know someone that you respect who would be a good fit for this position, please email:
Chase - Chase@praesumhealthcare.com Director of Talent Acquisition
Ray - RDavis@praesumhealthcare.com Executive Recruiter