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. Role Overview: As a Medical / Insurance Claims Analytics Consultant, you will play a crucial role in contributing to reducing claims friction, driving automation, delivering value, and transforming member experience in the healthcare industry. Key Responsibilities: - Contribute to use cases that have already reduced Medicare claim rejections by 7% and re-submissions by 70%. - Automate pre-auth and enrollment workflows to reduce manual efforts by up to 70%. - Partner with delivery and engineering teams to scale solutions with tangible ROI for clients. - Optimize claims transparency and resolution timelines to improve satisfaction and compliance. Qualifications Required: - Bachelors or Masters in Healthcare Informatics, Data Science, Statistics, or related field. - 3-7 years of hands-on experience in medical claims analytics within payer or provider environments. - Strong understanding of healthcare claims lifecycle, EDI formats (837/835), risk adjustment (HCC/RAF), and utilization review. - Experience working with Medicare, Medicaid, or ACA programs 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. At MinutestoSeconds, we are committed to leveraging your expertise to make a significant impact in the healthcare industry. Join our team and be a part of our mission to revolutionize medical claims analytics and improve client satisfaction. 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. Role Overview: As a Medical / Insurance Claims Analytics Consultant, you will play a crucial role in contributing to reducing claims friction, driving automation, delivering value, and transforming member experience in the healthcare industry. Key Responsibilities: - Contribute to use cases that have already reduced Medicare claim rejections by 7% and re-submissions by 70%. - Automate pre-auth and enrollment workflows to reduce manual efforts by up to 70%. - Partner with delivery and engineering teams to scale solutions with tangible ROI for clients. - Optimize claims transparency and resolution timelines to improve satisfaction and compliance. Qualifications Required: - Bachelors or Masters in Healthcare Informatics, Data Science, Statistics, or related field. - 3-7 years of hands-on experience in medical claims analytics within payer or provider environments. - Strong understanding of healthcare claims lifecycle, EDI formats (837/835), risk adjustment (HCC/RAF), and utilization review. - Experience working with Medicare, Medicaid, or ACA programs 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. At MinutestoSeconds, we are committed to leveraging your expertise to make a significant impact in the healthcare industry. Join our team and be a part of our mission to revolutionize medical claims analytics and improve client satisfaction.