Medical / Insurance Claims Analytics Consultant

MinutestoSeconds is a dynamic organization specializing in outsourcing services, digital marketing, IT recruitment, and custom IT projects. We partner with SMEs, mid-sized companies, and niche professionals to deliver tailored solutions. As a Medical / Insurance Claims Analytics Consultant at MinutestoSeconds, you will have the opportunity to work on various projects aimed at improving healthcare claims processes and enhancing member experiences. **Key Responsibilities:** - Reducing Claims Friction: You will contribute to use cases that have already reduced Medicare claim rejections by 7% and re-submissions by 70%. - Driving Automation: Your role will involve automating pre-authorization and enrollment workflows, reducing manual efforts by up to 70%. - Delivering Value: Collaborate with delivery and engineering teams to scale solutions with tangible ROI for our clients. - Transforming Member Experience: Optimize claims transparency and resolution timelines to improve satisfaction and compliance. **Qualifications Required:** - Bachelors or Masters in Healthcare Informatics, Data Science, Statistics, or a related field. - Strong understanding of the healthcare claims lifecycle, EDI formats (837/835), risk adjustment (HCC/RAF), and utilization review. - Experience working with Medicare, Medicaid, or ACA programs is preferred. - Proficiency in SQL, Python, or R, and data visualization tools (e.g., Tableau, Power BI). - Familiarity with AI/ML techniques and tools used in healthcare analytics. - Strong communication and stakeholder management skills. If you are someone with 3-7 years of experience in the field and possess the qualifications mentioned above, we would love to have you join our team at MinutestoSeconds!,