Job Description: AR Analyst - US Healthcare Company: Bandi Informatics Private Limited Location: Chennai, Tamilnadu, India Work Timings: 6:00 PM - 2:30 AM IST (Night Shift) Work Mode: On-site (Work from Chennai Office Only) About Bandi Informatics Private Limited: Bandi Informatics is a dynamic and growing organization providing specialized services within the healthcare sector. We pride ourselves on delivering high-quality solutions and fostering a collaborative work environment. Job Summary: We are seeking a detail-oriented and motivated Accounts Receivable (AR) Analyst to join our dedicated US Healthcare team. The AR Analyst will be responsible for managing the accounts receivable cycle for our US-based healthcare clients, focusing on resolving unpaid claims, analyzing denials, and ensuring timely payment collection from insurance payers. This role requires working during US business hours from our Chennai office. Key Responsibilities: Analyze and follow up on outstanding insurance claims for US healthcare providers. Identify, investigate, and resolve claim denials by reviewing Explanation of Benefits (EOBs), Remittance Advice (RAs), and payer correspondence. Initiate appeals and resubmit corrected claims to insurance companies via phone calls, payer portals, or other required methods. Monitor AR aging reports and prioritize follow-up activities to maximize collections and minimize bad debt. Accurately document all follow-up actions and findings in the relevant billing systems. Communicate effectively with US insurance payers to inquire about claim status and resolve payment discrepancies. Identify denial trends and report findings to management for process improvement. Ensure compliance with HIPAA regulations and client-specific guidelines. Collaborate with other team members and departments to resolve complex billing issues. Meet defined productivity and quality targets. Required Qualifications & Skills: Minimum 1-3 years of experience specifically in US Healthcare Accounts Receivable (AR) follow-up or Denial Management. Strong understanding of the US healthcare revenue cycle management (RCM) process, including medical billing, coding concepts (CPT, ICD-10), and insurance terminology. Proven experience working with major US insurance payers (e.g., Medicare, Medicaid, Commercial Insurances) and navigating their online portals. Excellent analytical and problem-solving skills with high attention to detail. Strong verbal and written communication skills in English, suitable for professional interaction with US counterparts. Proficiency in Microsoft Office Suite, particularly Excel. Ability to work independently and manage time effectively in a target-driven environment. Willingness and ability to work the mandatory night shift (6:00 PM - 2:30 AM IST) from our Chennai office. Bachelor's degree in Commerce, Finance, Business Administration, or a related field is preferred. To Apply: Please submit your resume and a self-introduction audio recording via WhatsApp to +91 9840020085. Alternatively, you may call the same number.
Bandi Informatics Pvt. Ltd. is a leading provider of medical scribe services to healthcare organizations of all sizes. We are looking for experienced and motivated live medical scribes to join our team. Provident fund
We are seeking a highly motivated and detail-oriented Pharmacist to join our team as a Medical Records Specialist. In this role, you will play a crucial part in ensuring the accuracy, completeness, and confidentiality of patient medical records, with a focus on medication-related information. You will collaborate with healthcare professionals, patients, and other stakeholders to maintain high-quality records that support safe and effective patient care. Responsibilities: Review and analyze patient medical records to identify medication-related issues, discrepancies, or potential drug interactions. Ensure accurate documentation of medication history, allergies, and adverse reactions. Collaborate with physicians, nurses, and other healthcare providers to clarify medication orders and resolve any discrepancies. Maintain up-to-date knowledge of relevant regulations and guidelines related to medical record keeping and patient privacy (HIPAA). Contribute to quality improvement initiatives by identifying trends, patterns, or areas for improvement in medication-related documentation. Provide education and training to healthcare professionals on proper documentation practices and medication safety. Respond to inquiries from patients, healthcare providers, and other stakeholders regarding medication-related information in medical records. Qualifications: Doctor of Pharmacy (Pharm.D.) degree from an accredited institution. Strong understanding of medical terminology, pharmacology, and drug interactions. Excellent attention to detail and ability to maintain accuracy in record keeping. Strong communication and interpersonal skills to effectively collaborate with healthcare professionals and patients. Knowledge of relevant regulations and guidelines related to medical record keeping and patient privacy (HIPAA). Ability to work independently and as part of a team. Proficiency in using electronic health record (EHR) systems and other relevant software. Preferred Qualifications: Experience in medical record review or clinical pharmacy practice. Certification in a relevant area, such as medication therapy management or informatics. WhatsApp / Phone : 9840020085
Bandi Informatics is seeking a highly skilled and motivated AI Specialist to join our growing team in Chennai. This role will primarily focus on developing and implementing Artificial Intelligence solutions for our USA healthcare clients. The ideal candidate will possess a strong understanding of AI/ML principles, experience with healthcare data, and the ability to work effectively during US business hours. Key Responsibilities: AI/ML Model Development: Design, develop, train, and deploy AI and Machine Learning models tailored for various healthcare applications, including but not limited to: Medical imaging analysis (e.g., disease detection, segmentation) Natural Language Processing (NLP) for clinical text analysis (e.g., electronic health records, patient notes, medical reports) Predictive analytics for patient outcomes, disease progression, or resource optimization. Automation of healthcare administrative processes (e.g., medical billing, transcription quality assurance). Data Preprocessing and Feature Engineering: Work with large, complex, and often unstructured healthcare datasets. This includes data cleaning, transformation, normalization, and creating relevant features for model training. Model Evaluation and Optimization: Evaluate the performance of AI/ML models using appropriate metrics, perform hyperparameter tuning, and implement strategies for continuous model improvement. Algorithm Selection and Customization: Research and select appropriate AI/ML algorithms (e.g., deep learning, supervised learning, unsupervised learning) based on specific problem statements and data characteristics. Customize and adapt algorithms as needed for optimal performance in healthcare contexts. Collaboration with Domain Experts: Work closely with healthcare professionals, data scientists, and software developers to understand requirements, translate business problems into AI solutions, and integrate AI models into existing systems. Staying Updated: Keep abreast of the latest advancements in AI/ML, particularly in the healthcare domain, and evaluate their potential application to Bandi Informatics' projects. Documentation and Reporting: Document model architectures, methodologies, results, and insights clearly and concisely. Prepare reports and presentations for both technical and non-technical stakeholders. Compliance and Ethics: Ensure all AI development adheres to healthcare data privacy regulations (e.g., HIPAA) and ethical AI principles. Required Skills and Qualifications: Bachelor's or Master's degree in Computer Science, Artificial Intelligence, Machine Learning, Data Science, Biomedical Engineering, or a related quantitative field. Proven experience (X years, specific number negotiable based on seniority) in developing and deploying AI/ML solutions, with a strong portfolio of projects. Solid understanding of machine learning algorithms (e.g., regression, classification, clustering, ensemble methods) and deep learning frameworks (e.g., TensorFlow, PyTorch, Keras). Proficiency in programming languages such as Python (with libraries like scikit-learn, NumPy, Pandas) and experience with data visualization tools. Experience working with healthcare data, including knowledge of medical terminologies (e.g., ICD, CPT) and healthcare data standards. Strong analytical and problem-solving skills with the ability to work independently and collaboratively. Excellent communication and interpersonal skills to effectively collaborate with cross-functional teams and present complex technical information. Ability to work the specified shift timings (6:00 PM to 2:30 AM IST) to overlap with USA healthcare business hours. Preferred Skills (Nice to Have): Experience with cloud platforms (AWS, Azure, GCP) for deploying and managing AI/ML models. Familiarity with MLOps practices for model deployment, monitoring, and maintenance. Knowledge of medical imaging modalities (e.g., X-ray, MRI, CT) and relevant image processing techniques. Prior experience in a BPO or ITES environment serving international clients.
Job Posting: Patient Calling Executive - USA Healthcare Process Bandi Informatics Private Limited is seeking a dedicated and professional Patient Calling Executive to join our team in Chennai. This is an excellent opportunity for individuals with strong communication skills and a passion for the healthcare industry to contribute to a vital part of the US healthcare system. About Us: Bandi Informatics Private Limited is a leading provider of IT and ITES services, with a strong focus on the healthcare sector. We specialize in medical transcription, medical billing, and other back-office assignments for our global clients. With over two decades of experience, we are committed to delivering high-quality, cost-effective solutions with a focus on confidentiality and data integrity. Role Summary: As a Patient Calling Executive, you will be the primary point of contact for patients in the USA, acting as a bridge between them and healthcare providers. Your main responsibility will be to manage outbound calls for various healthcare-related tasks, ensuring clear, effective, and empathetic communication. This role is crucial for enhancing patient engagement and satisfaction while adhering to strict healthcare regulations. Key Responsibilities: Make outbound calls to patients in the USA for purposes such as appointment reminders, follow-ups on care, and providing information. Update and maintain patient records with call outcomes and necessary follow-up actions. Handle patient inquiries and concerns with a professional and empathetic approach. Collaborate with healthcare providers and other team members to ensure timely and accurate communication. Adhere strictly to all HIPAA (Health Insurance Portability and Accountability Act) regulations to maintain patient confidentiality and data security. Assist with administrative tasks as needed to support smooth healthcare operations. Required Skills and Qualifications: A high school diploma or equivalent is required; a background in healthcare or customer service is preferred. Excellent verbal communication skills with a neutral accent and a professional telephone demeanor. Strong interpersonal skills and the ability to handle sensitive information with discretion and empathy. Proficiency in data entry and basic computer applications. Strong organizational and time-management skills with a keen attention to detail. Familiarity with medical terminology and healthcare processes is a plus. Ability to work in a fast-paced environment and handle multiple tasks efficiently. Why Join Us? Be a part of a company with a strong reputation for excellence in the healthcare BPO sector. Contribute to a service that directly impacts patient care and satisfaction. Competitive salary and benefits. Opportunities for continuous learning and career growth within the organization. Location: Chennai, India (in-office position) Shift: Night Shift (to align with US business hours) Contact us by phone or WhatsApp at 9840020085. ( https://wa.me/919840020085 )
RPA Developer at Bandi Informatics Pvt Ltd Are you a highly motivated and independent RPA Developer looking for a new challenge? Bandi Informatics, a leading provider of solutions for the USA healthcare sector, is seeking a dedicated individual to join our team. About Bandi Informatics Established in 1999, Bandi Informatics Private Limited has been a trusted partner in the healthcare industry for over two decades. We specialize in leveraging cutting-edge technology, including AI integration , to streamline processes and improve efficiency for our clients. Our collaborative and dynamic environment encourages innovation and recognizes individual contributions. The Role We are looking for a skilled and hardworking RPA Developer who thrives in a solo environment. You will be responsible for the end-to-end development and implementation of automation solutions, from design to deployment. A strong ability to manage your time and meet deadlines is crucial for success in this role. Key Responsibilities Design, develop, and deploy RPA solutions to automate business processes. Work independently to manage multiple projects and meet strict deadlines. Collaborate with stakeholders to understand business requirements and translate them into technical specifications. Monitor and maintain automation bots to ensure optimal performance. Identify opportunities for process improvement and new automation initiatives. Qualifications Proven experience as an RPA Developer , with a strong portfolio of successfully delivered projects. Exceptionaltime management and organizational skills. A track record of achieving deadlines and working effectively without constant supervision . Experience with UiPath is a significant advantage. Knowledge of the USA healthcare sector is a plus. Strong problem-solving and analytical abilities. Why Join Us? At Bandi Informatics, youll have the opportunity to make a direct impact on our operations and our clients' success. We value individual initiative and dedication , offering a rewarding environment where your hard work is recognized. Location Chennai, India If you are a self-starter with a passion for automation and a desire to excel, we encourage you to apply. Do WhatsApp our CEO Mr. Bandi at 9840020085 to apply for this position.
We have immediate openings for Medical Records Reviewer; we are looking for experienced candidates in MRR who have experience in eClinicalWorks. Role & responsibilities We need team members who are detail-oriented and can: Review patient charts and cancel expired orders Receive and process reports, such as referrals Create and fax letters to providers Receive other reports. Preferred candidate profile English communication, as this is an American organization.
Bandi Informatics Pvt. Ltd. is a leading provider of medical scribe services to healthcare organizations of all sizes. We are looking for experienced and motivated live medical scribes to join our team. As a live medical scribe, you will work alongside physicians and other healthcare professionals to document patient encounters in real time. You will be responsible for accurately and efficiently recording the patient's medical history, chief complaint, physical exam findings, physician assessments, and treatment plans. Responsibilities: Document patient encounters in real time using electronic health record (EHR) (Eclinical Works - ECW) software Accurately and efficiently record the patient's medical history, chief complaint, physical exam findings, physician assessments, and treatment plans Communicate effectively with physicians and other healthcare professionals Maintain patient confidentiality at all times Qualifications: High school diploma or equivalent Experience with EHR(Eclinical Works - ECW) software Strong typing and computer skills Excellent communication and interpersonal skills Ability to work independently and as part of a team Ability to multitask and work under pressure Benefits: Competitive salary and benefits package Flexible work schedule Opportunities for professional development
Our firm, headquartered in New York, seeks an exceptional Personal Assistant (PA) to provide comprehensive, 24/7 support to our CEO. The role is based in our Chennai, India office, with primary working hours from 6:00 PM to 2:30 AM IST, though full availability is required to meet the CEOs needs. This high-pressure position demands perfection, supporting a CEO who is highly demanding, time-constrained, and expects flawless execution.Key Qualifications Graduate degree required; education from Oxford or an equivalent top-tier institution preferred. Tri-lingual with superior verbal and written communication skills. Proficient in leveraging AI tools for tasks such as drafting and personalizing communications, conducting research, and managing technical integrations (e.g., linking accounts like Claude to Microsoft without involving the CEO). Proven experience as a Personal Assistant to a CEO or high-profile individual required. Self-motivated, proactive, and professional, with a zero-drama approach and no need for unnecessary flattery. Exceptional client-service orientation, with a focus on anticipating and resolving the CEO’s needs, from minor details to complex logistics. Must sign a Non-Disclosure Agreement (NDA) and be able to travel to the USA. Sharp intellect, highly responsive, and personally invested in the CEO’s satisfaction, demonstrating genuine concern if the CEO is dissatisfied. Responsibilities Daily Support: Manage all aspects of travel, including booking flights, hotels, and transportation; handle disruptions (e.g., flight delays) by securing accommodations, arranging meals, rebooking travel, adjusting schedules, and notifying relevant stakeholders. Coordinate high-demand reservations, such as dinners at exclusive restaurants or tickets to sold-out events (e.g., UFC, conferences, or shows). Oversee personal tasks, including prescription refills, relaying messages. Master internal systems, such as Waystar, to support operational needs. Proactive Management: Monitor and remind the CEO and team of deadlines, travel schedules, and calendar conflicts; propose actionable solutions and escalate issues if deadlines are missed. Independently research and report on key objectives (e.g., ensuring hospital readmission rates meet 6% for 30 days and 9% for 90 days; tracking financial claims, such as $300K resubmissions). Business Leadership: When not directly supporting the CEO, proactively advance Horizon goals across the global team, engaging all relevant stakeholders. Collaborate with the CEO and manage facilities through on-ground staff. Communication and Diplomacy: Communicate primarily via text for rapid response to the CEO’s needs. Redirect vendors and employees with firmness and diplomacy to resolve issues without involving the CEO; escalation to the CEO indicates failure. AI-Driven Support: Conduct AI-driven research on topics relevant to the CEO’s interests or priorities. Handle technical tasks, such as account integrations or payment coordination, seamlessly without involving the CEO in details. Full 24/7 availability required, despite primary office hours of 6:00 PM to 2:30 AM IST in Chennai. Start date: Immediate, within the current month. Examples of Expected Performance Travel Disruption: During a flight delay, secure a hotel, arrange transportation, rebook flights, provide meals, adjust the CEO’s calendar, and notify the team promptly. Routine Tasks: Arrange exclusive dinner reservations, prompt staff to handle prescription pickups, or ensure the CEO’s office is stocked with essentials. Proactive Initiatives: Independently monitor and report on key metrics (e.g., address unmet readmission rate targets with pharmacists), track financial claims, and propose calendar conflict resolutions. High-Demand Tasks: Secure tickets to sold-out events, book reservations at high-demand restaurants, and manage complex travel logistics flawlessly. Additional Requirements Deliver impeccable performance with no tolerance for errors. Demonstrate resilience and professionalism in a challenging, high-pressure environment. Work primarily from the Chennai office (6:00 PM to 2:30 AM IST), with 24/7 availability to meet the CEO’s needs and potential travel to the USA.
Our firm, headquartered in New York, seeks an exceptional Project Manager support to our CEO in Newyork. The role is based in our Chennai, India office, with primary working hours from 6:00 PM to 2:30 AM IST, though full availability is required to meet the CEOs needs. This high-pressure position demands perfection, supporting a CEO who is highly demanding, time-constrained, and expects flawless execution.Key About the Role: We are seeking a highly motivated and resilient Project Manager to join our growing medical group in a critical role reporting directly to the CEO. This is a fast-paced, high-impact position where you will be responsible for managing multiple concurrent projects with firm deadlines in a dynamic healthcare environment. This role requires someone who thrives under pressure, maintains composure in stressful situations, and delivers results consistently. Due to the demanding nature of this position, compensation has been set at a premium level to reflect the expectations and commitment required. Key Responsibilities: Manage and execute strategic projects from initiation through completion, ensuring all deliverables are met on time and within scope Work directly with the CEO to prioritize initiatives, provide status updates, and troubleshoot challenges in real-time Develop and maintain detailed project timelines, track milestones, and hold team members accountable to deadlines Conduct research and analysis on healthcare operations, billing optimization, compliance requirements, contract terms, and other business-critical topics as assigned Build and maintain complex Excel spreadsheets for data analysis, financial modeling, and reporting Coordinate cross-functionally with clinical staff, billing teams, and administrative personnel to drive project success Anticipate roadblocks, identify solutions proactively, and adapt quickly to changing priorities Document processes, maintain organized project files, and ensure all stakeholders have access to critical information Receive and implement feedback quickly, adjusting approach based on leadership direction Required Qualifications: Proven experience in project management or similar role managing multiple competing deadlines Advanced proficiency in Microsoft Excel (pivot tables, VLOOKUP, formulas, data analysis) Exceptional organizational skills with meticulous attention to detail Strong research and analytical capabilities with ability to synthesize complex information quickly Demonstrated ability to learn new concepts, systems, and processes rapidly Resilience and composure under pressure with ability to receive direct feedback constructively Excellent written and verbal communication skills Ability to work independently with minimal supervision while knowing when to escalate issues Reliable, accountable, and committed to meeting deadlines without exception Preferred Qualifications: Experience in healthcare administration, medical practice management, or healthcare operations a plus Familiarity working with C-Suite level executives Knowledge of EHR systems (eClinicalWorks experience a plus) Bachelor's degree in Business Administration, Healthcare Administration, or related field What We Offer: Competitive compensation package commensurate with the demanding nature of the role Direct exposure to executive-level decision making and strategic initiatives Opportunity for rapid professional growth in a healthcare organization Hands-on experience across multiple facets of medical practice operations Work Environment: This position requires someone who can handle high-stakes situations, tight deadlines, and direct communication. You will be expected to manage stress effectively, pivot quickly when priorities shift, and maintain high-quality output even under pressure. If you thrive in demanding environments and want a role where your contributions directly impact organizational success, this is the opportunity for you. Additional Requirements Deliver impeccable performance with no tolerance for errors. Demonstrate resilience and professionalism in a challenging, high-pressure environment. Work primarily from the Chennai office (6:00 PM to 2:30 AM IST), with 24/7 availability to meet the CEOs needs and potential travel to the USA. About Bandi Informatics Bandi Informatics Private Limited, a Chennai-based leader in IT-enabled services since 1999, specializes in healthcare data management and business process outsourcing. Headquartered in Chennai with a strategic partnership supporting a New York-based medical group, we deliver high-quality solutions to global clients. Join our dynamic team to drive impactful projects in a fast-paced, innovative environment
CCLF Data Analyst at Bandi Informatics Private Limited Company Overview Bandi Informatics Private Limited is a leading provider of healthcare analytics solutions, specializing in delivering actionable insights through advanced data processing and analytics for healthcare organizations. We are seeking a skilled CCLF Data Analyst to join our team and support our mission of transforming Medicare claims data into meaningful outcomes. Position: CCLF Data Analyst Location : Work from Office Only (Bandi Informatics Office, [Insert Office Location]) Work Timings : 6:00 PM to 2:30 AM IST (Fixed Schedule) Employment Type : Full-Time Transportation : Not Provided Work Arrangement : No Hybrid or Remote Option; Fully In-Office Job Summary As a CCLF Data Analyst at Bandi Informatics Private Limited, you will be responsible for processing, analyzing, and deriving insights from Claims and Claims Line Feed (CCLF) data provided by the Centers for Medicare & Medicaid Services (CMS). You will play a critical role in supporting healthcare organizations, such as Accountable Care Organizations (ACOs), by transforming raw Medicare fee-for-service (FFS) claims data into actionable reports and dashboards to optimize care coordination, cost management, and performance benchmarking. Key Responsibilities Data Ingestion and ETL : Automate the ingestion and transformation of monthly CCLF fixed-width text files (Parts A, B, and limited Part D data) using ETL pipelines. Data Cleaning and Validation : Handle deduplication across regular and run-out files, map beneficiary IDs, and resolve inconsistencies in enrollment or eligibility data. Data Analysis : Write complex SQL queries and use Python for advanced analytics to derive metrics such as utilization trends, expenditure reports, and quality measures (e.g., readmissions, IP+ED visits). Reporting and Visualization : Create dashboards and reports using tools like Tableau or Power BI to support stakeholder decision-making. Compliance : Ensure data handling complies with HIPAA and CMS security guidelines, maintaining strict confidentiality. Collaboration : Work closely with data engineers and healthcare stakeholders to translate clinical and financial questions into data-driven insights. Required Skills and Qualifications Education : Bachelors degree in Data Science, Computer Science, Healthcare Informatics, or a related field. Experience : 2+ years of experience in healthcare data analytics, preferably with Medicare FFS claims or CCLF data. Proven expertise in ETL processes and data pipeline tools (e.g., Apache Airflow, dbt). Technical Skills : Proficiency in SQL for querying large datasets and Python (Pandas, NumPy) for data processing. Experience with data warehousing solutions (e.g., Snowflake, BigQuery) and visualization tools (e.g., Tableau, Power BI). Familiarity with healthcare data standards (e.g., ICD-10, CPT codes) and CMS data formats. Domain Knowledge : Understanding of Medicare Shared Savings Program (MSSP), ACO workflows, or population health analytics. Soft Skills : Strong problem-solving skills, attention to detail, and ability to communicate complex insights to non-technical stakeholders. Availability : Must be comfortable with the fixed work schedule of 6:00 PM to 2:30 AM IST and working from the office. Preferred Qualifications Experience with CMSs Medicare Analytics Data Engine (MADE) or similar platforms. Familiarity with healthcare-specific libraries (e.g., FHIR crosswalks, Tuva Projects CCLF connector). Knowledge of Microsoft Fabric for healthcare analytics. Call / Whatsapp : 9840020085
International Voice Process Bandi Informatics Pvt. Ltd. Bandi Informatics Pvt. Ltd., a leading provider of global business process outsourcing solutions, is looking for experienced and motivated professionals to join our International Voice Process team. As a part of our customer support division, you will communicate with international clients to provide exceptional service, resolve queries, and ensure customer satisfaction through voice-based interactions. Responsibilities: Handle inbound and outbound calls for international clients with professionalism and clarity Provide accurate information and effective solutions to customer queries Maintain detailed records of customer interactions in the CRM system Meet performance metrics related to quality, accuracy, and efficiency Collaborate with internal teams to resolve customer concerns promptly Qualifications: High school diploma or equivalent; bachelors degree preferred Minimum 1 year of experience in an international voice process or customer support role Excellent English communication and interpersonal skills Ability to handle high-pressure situations with composure Strong computer literacy and multitasking abilities Willingness to work in rotational shifts including night shifts Benefits: Competitive salary and performance-based incentives Health insurance and other benefits Opportunities for professional growth and skill development Supportive and dynamic work environment Call or Whatapp : 9840020085 -Bandi Informatics Private Limited .
CCLF Data Analyst at Bandi Informatics Private Limited Company Overview Bandi Informatics Private Limited is a leading provider of healthcare analytics solutions, specializing in delivering actionable insights through advanced data processing and analytics for healthcare organizations. We are seeking a skilled CCLF Data Analyst to join our team and support our mission of transforming Medicare claims data into meaningful outcomes. Position: CCLF Data Analyst Location : Work from Office Only (Bandi Informatics Office, [Insert Office Location]) Work Timings : 6:00 PM to 2:30 AM IST (Fixed Schedule) Employment Type : Full-Time Transportation : Not Provided Work Arrangement : No Hybrid or Remote Option; Fully In-Office Job Summary As a CCLF Data Analyst at Bandi Informatics Private Limited, you will be responsible for processing, analyzing, and deriving insights from Claims and Claims Line Feed (CCLF) data provided by the Centers for Medicare & Medicaid Services (CMS). You will play a critical role in supporting healthcare organizations, such as Accountable Care Organizations (ACOs), by transforming raw Medicare fee-for-service (FFS) claims data into actionable reports and dashboards to optimize care coordination, cost management, and performance benchmarking. Key Responsibilities Data Ingestion and ETL : Automate the ingestion and transformation of monthly CCLF fixed-width text files (Parts A, B, and limited Part D data) using ETL pipelines. Data Cleaning and Validation : Handle deduplication across regular and run-out files, map beneficiary IDs, and resolve inconsistencies in enrollment or eligibility data. Data Analysis : Write complex SQL queries and use Python for advanced analytics to derive metrics such as utilization trends, expenditure reports, and quality measures (e.g., readmissions, IP+ED visits). Reporting and Visualization : Create dashboards and reports using tools like Tableau or Power BI to support stakeholder decision-making. Compliance : Ensure data handling complies with HIPAA and CMS security guidelines, maintaining strict confidentiality. Collaboration : Work closely with data engineers and healthcare stakeholders to translate clinical and financial questions into data-driven insights. Required Skills and Qualifications Education : Bachelors degree in Data Science, Computer Science, Healthcare Informatics, or a related field. Experience : 2+ years of experience in healthcare data analytics, preferably with Medicare FFS claims or CCLF data. Proven expertise in ETL processes and data pipeline tools (e.g., Apache Airflow, dbt). Technical Skills : Proficiency in SQL for querying large datasets and Python (Pandas, NumPy) for data processing. Experience with data warehousing solutions (e.g., Snowflake, BigQuery) and visualization tools (e.g., Tableau, Power BI). Familiarity with healthcare data standards (e.g., ICD-10, CPT codes) and CMS data formats. Domain Knowledge : Understanding of Medicare Shared Savings Program (MSSP), ACO workflows, or population health analytics. Soft Skills : Strong problem-solving skills, attention to detail, and ability to communicate complex insights to non-technical stakeholders. Availability : Must be comfortable with the fixed work schedule of 6:00 PM to 2:30 AM IST and working from the office. Preferred Qualifications Experience with CMSs Medicare Analytics Data Engine (MADE) or similar platforms. Familiarity with healthcare-specific libraries (e.g., FHIR crosswalks, Tuva Projects CCLF connector). Knowledge of Microsoft Fabric for healthcare analytics. Call / Whatsapp : 9840020085
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