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This role is a Full‑Time HealthCare Claims Analyst based in New York, NY, offering a competitive salary of $58,039.46 to $65,294.40. Requires 5 years of healthcare claims experience, advanced SQL and Excel skills, and knowledge of Medicaid/Medicare guidelines.
Location: New York, NY Schedule: Hybrid
Job Summary Join VillageCare as a Full‑Time HealthCare Claims Analyst and take your career to the next level while working from the comfort of your home. This position offers great financial incentives and a flexible work‑life balance through a hybrid schedule.
Responsibilities
Analyze healthcare reimbursement from both financial and operational perspectives.
Conduct audits and perform root‑cause analysis to resolve identified issues with internal teams and TPAs.
Identify gaps in claims processing; communicate trends and contract issues to management.
Prepare comprehensive narratives and visual aids for leadership presentations.
Coordinate workflows across departments, ensuring compliance with regulations.
Develop policies and quality assurance measures to improve operational efficiency.
Qualifications
Minimum of 5 years experience in healthcare claims reporting and processing.
Advanced SQL coding and Excel skills for creating insightful reports and dashboards.
Strong knowledge of Medicaid and Medicare guidelines, ICD‑10, CPT, HCPCS, CMS guidelines, EncoderPro.
Bachelor’s Degree in Computer Science, Mathematics, Statistics, Engineering (Master’s preferred).
Excellent written and verbal communication skills.
Ability to work independently with high productivity.
Knowledge And Skills Required
Education: Bachelor’s Degree required (Master’s preferred).
Minimum 3–5 years of business intelligence and analytics experience.
Familiarity with medical terminology and coding systems.
Proficiency in MS Excel, SQL, Tableau, Access.
Strong communication and independent work capabilities.
Benefits include Medical, Dental, Vision, Life Insurance, Health Savings Account, Paid Time Off.
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This role is a Full‑Time HealthCare Claims Analyst based in New York, NY, offering a competitive salary of $58,039.46 to $65,294.40. Requires 5 years of healthcare claims experience, advanced SQL and Excel skills, and knowledge of Medicaid/Medicare guidelines.
Location: New York, NY Schedule: Hybrid
Job Summary Join VillageCare as a Full‑Time HealthCare Claims Analyst and take your career to the next level while working from the comfort of your home. This position offers great financial incentives and a flexible work‑life balance through a hybrid schedule.
Responsibilities
Analyze healthcare reimbursement from both financial and operational perspectives.
Conduct audits and perform root‑cause analysis to resolve identified issues with internal teams and TPAs.
Identify gaps in claims processing; communicate trends and contract issues to management.
Prepare comprehensive narratives and visual aids for leadership presentations.
Coordinate workflows across departments, ensuring compliance with regulations.
Develop policies and quality assurance measures to improve operational efficiency.
Qualifications
Minimum of 5 years experience in healthcare claims reporting and processing.
Advanced SQL coding and Excel skills for creating insightful reports and dashboards.
Strong knowledge of Medicaid and Medicare guidelines, ICD‑10, CPT, HCPCS, CMS guidelines, EncoderPro.
Bachelor’s Degree in Computer Science, Mathematics, Statistics, Engineering (Master’s preferred).
Excellent written and verbal communication skills.
Ability to work independently with high productivity.
Knowledge And Skills Required
Education: Bachelor’s Degree required (Master’s preferred).
Minimum 3–5 years of business intelligence and analytics experience.
Familiarity with medical terminology and coding systems.
Proficiency in MS Excel, SQL, Tableau, Access.
Strong communication and independent work capabilities.
Benefits include Medical, Dental, Vision, Life Insurance, Health Savings Account, Paid Time Off.
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