ODAR Data Analyst - MedReview

Position Summary

At MedReview, our mission is to bring accuracy, accountability, and clinical excellence to healthcare.  As such, we are a leading authority in payment integrity solutions including DRG Validation, Cost Outlier and Readmission reviews.
The ODAR Resolution Analyst role is responsible for the monitoring, triaging, routing, and working audited claims flagged with an inquiry to (1) confirm action needed to facilitate resolution, and (2) ensuring confirmed action is taken by responsible teams. Position is also responsible for research and validation of assigned Prepay audit inventory to confirm status and savings attribution.

Responsibilities:

1. Understand the MedReview review and specific client workflows to:

• ‒ Understand the rationale and underlying client ask from a claim inquiry.
• ‒ Take all appropriate action to resolve the inquiry.
• ‒ When applicable, route the claim to other MedReview teams to take resolution action; and
• ‒ Monitor inventory to ensure timely resolution

2. Serve as the primary point of responsibility for managing audit inquiry inventory
3. Work with all internal departments to ensure advancement of tasks and resolution of account issues
4. Working with MedReview’s reporting team, ensure timely production and validation of PrePay savings                  reporting
5. Other client reporting, inventory oversight, and Shared Services support as assigned

Required Qualification:
 

· 3 years of either Inpatient Claim Billing or Inpatient Claim Adjudication Experience

· Knowledge and experience in healthcare claims processing

· Strong working knowledge of Microsoft Excel

· Proven ability to oversee simultaneous workflows with strong attention to detail

· Analytical skills demonstrating ability to collect, track and analyze data

· Demonstrated ability to communicate and collaborate with Operational stakeholders
 

Preferred:
 

· Ability to adapt quickly learn use of payment integrity vendor management software applications

· Experience and knowledge with healthcare claims payment integrity

Benefits and perks include:

• Healthcare that fits your needs - We offer excellent medical, dental, and vision plan options that provide coverage to employees and dependents.
• 401(k) with Employer Match - Join the team and we will invest in your future
• Generous Paid Time Off - Accrued PTO starting day one, plus additional days off when you’re not feeling well, to observe holidays.
• Wellness - We care about your well-being. From Commuter Benefits to FSAs we’ve got you covered.
• Learning & Development - Through continued education/mentorship on the job and our investment in LinkedIn Learning, we’re focused on your growth as a working professional.

Salary: $25/hr- $30/hr 

Powered by JazzHR