Data Scientist - Claims Review
United States
Engineering /
Full-time /
Remote
Health at Scale is the market leader in precision health -- digital health programs that offer smart, hyper-personalized insights to help individuals choose the best providers, treatments, care settings and lifestyle choices for their unique healthcare needs. Founded by leading machine learning and clinical faculty from MIT, Stanford, Harvard and the University of Michigan, we work with some of the largest payers, employers and providers in the U.S. to improve outcomes, costs, access, and equity for their members. Health at Scale operates some of the largest deployments of AI in healthcare to date, covering millions of lives in production settings. We have been recognized for our innovation and as one of the fastest growing private companies by Forbes, Fast Company, Inc 500, UCSF Digital Health, Becker's, TechCrunch, Bloomberg and MIT News. For more information, please visit our website.
As a Data Scientist involved in claims review, you will work with an exceptional team of clinicians, engineers and scientists to analyze healthcare data to improve payment workflows. You will collaborate with other team members to develop strategies to inform improvements to our products and bring in the next generation of payment integrity and claims processing technologies.
Responsibilities
- Conduct data analyses and evaluate healthcare claims for inappropriate utilization and/or reimbursement
- Work with healthcare professionals to identify potential cases and identify patterns of low-value care
- Conduct thorough analysis of healthcare claims and transactions
- Develop and implement strategies to improve payment integrity and claims processing
- Develop reports and presentations on cases for management and other stakeholders
- Stay current with healthcare regulations and policies
Requirements
- Bachelor's degree in a computer science, data science, informatics or statistics with excellent programming skills
- Proficiency in Python programming language, database queries, and SQL
- Highly desirable to have healthcare data and subject-matter experience related to identifying patterns of low-value care
- Strong analytical and problem-solving skills, well-organized and with thorough attention to detail
- Excellent communication and interpersonal skills with ability to work independently and as part of a team
Health at Scale is an equal opportunity employer and is committed to diversity in its hiring and business practices. To all recruitment agencies: Health at Scale does not accept agency resumes. Please do not forward resumes to this job alias, company employees or any organization location. Health at Scale is not responsible for any fees related to unsolicited resumes.
