Talent.com
Sr. Clinical Analyst
Sr. Clinical AnalystSmartLight Analytics • Plano, TX, US
Sr. Clinical Analyst

Sr. Clinical Analyst

SmartLight Analytics • Plano, TX, US
job_description.job_card.30_days_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
  • serp_jobs.filters_job_card.quick_apply
job_description.job_card.job_description

Position Overview :

  • The Senior Clinical Analyst role combines clinical data expertise with relationship management to ensure accurate claims processing, resolve billing discrepancies, and optimize carrier performance.
  • The analyst plays a key role in identifying improper payments, communicating findings, and driving resolution through data-backed insights.

This is NOT a Data Analyst Position with SQL and data sets.  Responsibilities :

  • Possess a clear understanding of the identification and investigation of issues and billing activities leading to improper payments is required as this work involves reviewing medical claims data (professionals, facilities, insured members, or the broker community).
  • Utilize information from claims data analysis, plan representatives and other sources to accurately present the company’s findings to carriers in a way ensuring they will understand the issues and take recommended actions to remediate said inappropriate payments.
  • Identify, analyze, and interpret trends or patterns in complex data sets Leverage available resources and systems (both internal and external) to analyze claim information and take appropriate action for payment resolution Perform review of claims resulting from overpayments related to benefits and policies Consider the financial impact of referrals with regard to identified savings and the potential of favorable resolution during the approval process Communicate and document findings, including trends and recommendations  Ability to review and analyze medical records.

    • Qualifications :

  • Bachelor's degree in healthcare or related field, preferred At least one of : RN, CPC, CCS or other relevant clinical / coding certifications required, Multiple would be preferred A minimum of 5 years of experience in healthcare payment integrity, clinical auditing or claims management Experience in commercial payer environments Strong critical-thinking, communication and attention to detail skills Who is SmartLight Analytics SmartLight Analytics was formed by a group of industry insiders who wanted to make a meaningful impact on the rising cost of healthcare.
  • With this end in mind, SmartLight works for self-funded employers to reduce wasteful spending in their healthcare plan through our proprietary data analysis.
  • Our process works behind the scenes to save money without interrupting employee benefits or requiring employee behavior changes.   Powered by JazzHR
    • serp_jobs.job_alerts.create_a_job

    Sr Analyst • Plano, TX, US

    Job_description.internal_linking.related_jobs
    Travel Physical Therapist (PT) - $1,940 per week in Mckinney, TX

    Travel Physical Therapist (PT) - $1,940 per week in Mckinney, TX

    Core Medical Group • Mckinney, TX, US
    serp_jobs.job_card.full_time
    CoreMedical Group has hundreds of exciting and rewarding travel assignments throughout the country for Travel Allied Professionals and Travel Nurses. Plus, we're the only healthcare staffing company...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Sr. Analyst, Connected Technologies Sourcing

    Sr. Analyst, Connected Technologies Sourcing

    Toyota Motor Sales, U.S.A., Inc. • Plano, TX, United States
    serp_jobs.job_card.full_time
    These are just a few words that describe what life is like at Toyota.As one of the world's most admired brands, Toyota is growing and leading the future of mobility through innovative, high-quality...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel Nurse RN - Intensive Care Unit (ICU) / Critical Care - $1,422 to $1,580 per week in Plano, TX

    Travel Nurse RN - Intensive Care Unit (ICU) / Critical Care - $1,422 to $1,580 per week in Plano, TX

    TravelNurseSource • Plano, TX, US
    serp_jobs.job_card.full_time
    TravelNurseSource is working with All Medical Personnel to find a qualified ICU / Critical Care RN in Plano, Texas, 75075!. Assist physicians with patient management.Provide patient care to patients.C...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel CT Tech - $2,196 to $2,396 per week in McKinney, TX

    Travel CT Tech - $2,196 to $2,396 per week in McKinney, TX

    Titan Medical Group • McKinney, TX, US
    serp_jobs.job_card.full_time
    ARRT(CT) / BCLS / BLS - American Heart Association.Titan Medical is looking for travelers to fill a Travel CT Technologist position for a 13 week assignment in McKinney, TX! Call Titan for additional d...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Clinical Supervisor, BCBA - Up to 5K Sign on Bonus

    Clinical Supervisor, BCBA - Up to 5K Sign on Bonus

    Accel Therapies • Frisco, TX, US
    serp_jobs.job_card.full_time
    Arial, sans-serif;"> Clinical Supervisor (...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_1_day • serp_jobs.job_card.promoted
    Travel CT Technologist

    Travel CT Technologist

    Nightingale Nurses • McKinney, TX, US
    serp_jobs.job_card.full_time
    Nightingale Nurses is seeking a travel CT Technologist for a travel job in McKinney, Texas.Job Description & Requirements. You may not realize it, but as an RN with real world hospital experienc...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Travel CT Technologist

    Travel CT Technologist

    ADEX Healthcare Staffing LLC • McKinney, TX, US
    serp_jobs.job_card.full_time
    ADEX Healthcare Staffing LLC is seeking a travel CT Technologist for a travel job in McKinney, Texas.Job Description & Requirements. Travel or Local Allied Healthcare Professional needed for ASA...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Sr. Analyst

    Sr. Analyst

    Invitation Homes • Dallas, TX, United States
    serp_jobs.job_card.full_time
    Invitation Homes (NYSE : INVH) is the leading owner and operator of single-family rental homes in the United States with a portfolio of over 100,000 owned and managed high-quality homes in over 16 m...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel CT Technologist

    Travel CT Technologist

    GHR Healthcare - PH Division • McKinney, TX, US
    serp_jobs.job_card.full_time
    GHR Healthcare - PH Division is seeking a travel CT Technologist for a travel job in McKinney, Texas.Job Description & Requirements. Planet Healthcare Job ID #74390866.Pay package is based on 8 ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_1_day • serp_jobs.job_card.promoted
    Travel Cath Lab Tech - $1,961 to $2,174 per week in San Antonio, TX

    Travel Cath Lab Tech - $1,961 to $2,174 per week in San Antonio, TX

    LRS Healthcare • Dallas, Texas, US
    serp_jobs.job_card.full_time
    Ready to start your next travel adventure? LRS Healthcare offers a full benefits package, 24 / 7 support, and a responsive, traveler-first culture. What are you waiting for? Apply today!.Valid license...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel Physical Therapist (PT) - $1,965 per week in McKinney, TX

    Travel Physical Therapist (PT) - $1,965 per week in McKinney, TX

    Triage Staffing LLC • McKinney, TX, US
    serp_jobs.job_card.full_time
    Travel Rehab : Physical Therapy McKinney.Shift Details : 8H Days (12 : 00 AM-12 : 00 PM).Length : 13 WEEKS 13 weeks.Apply for specific facility details.serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    RN CVICU

    RN CVICU

    Baylor Scott & White Health • Plano, TX, US
    serp_jobs.job_card.full_time
    Position : RN CVICU + CVPVU + Tele (Universal Bed CUB Model).Shift : Full-time, Nights, 3x12s.Experience : CVICU or CVPCU highly preferred or strong ICU experience. The Registered Nurse (RN) is a licen...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Travel CVOR Tech - $1,391 per week in Plano, TX

    Travel CVOR Tech - $1,391 per week in Plano, TX

    AlliedTravelNetwork • Plano, TX, US
    serp_jobs.job_card.full_time
    AlliedTravelNetwork is working with Triage Staffing LLC to find a qualified CVOR Tech in Plano, Texas, 75023!.Travel Nursing : Cardiovascular OR Tech Plano, TX. Shift Details : 8H Days (7 : 00 AM-3 : 00...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    NICU RRT

    NICU RRT

    Medical City Frisco • Frisco, TX, US
    serp_jobs.job_card.full_time +1
    Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities.As a NICU RRT with Medical City Frisco you can be a part of an organization that is devoted to gi...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel CT Technologist

    Travel CT Technologist

    Malone Healthcare - Nursing • McKinney, TX, US
    serp_jobs.job_card.full_time
    Malone Healthcare - Nursing is seeking a travel CT Technologist for a travel job in McKinney, Texas.Job Description & Requirements. About Malone Healthcare - Nursing.With a commitment to pr...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel MRI Tech - $1,680 to $1,720 per week in Mckinney, TX

    Travel MRI Tech - $1,680 to $1,720 per week in Mckinney, TX

    AlliedTravelCareers • Mckinney, TX, US
    serp_jobs.job_card.full_time
    AlliedTravelCareers is working with Health Saviours to find a qualified MRI Tech in Mckinney, Texas, 75070!.Position : MRI Tech - Full time. Total Weekly Gross : $ 1720 weekly on 40 hours ($43 / hr).Wee...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel CT Technologist

    Travel CT Technologist

    CrossMed • McKinney, TX, US
    serp_jobs.job_card.full_time
    CrossMed is seeking a travel CT Technologist for a travel job in McKinney, Texas.Job Description & Requirements.At CrossMed Healthcare Staffing, we aim to create lasting impressions wherever we...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Travel CT Technologist

    Travel CT Technologist

    Genie Healthcare • McKinney, TX, US
    serp_jobs.job_card.full_time
    Genie Healthcare is seeking a travel CT Technologist for a travel job in McKinney, Texas.Job Description & Requirements.Genie Healthcare is looking for a Radiology / Imaging to work in CT Tech fo...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted