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Baton Rouge, Louisiana - USD Full Time Posted: Sunday, 13 August 2017
NCI: As the Data Analyst ( Data Analyst II ), you will perform in-depth evaluation and analysis of potential fraud cases and requests for information using claims information and other sources of data. You will also support the development of complex cases that involve high dollar amounts, sensitive issues, or that otherwise meet criteria for vulnerability identifications, referral to law enforcement, recoupment of overpayment, and/or administrative action based on reactive and proactive data analysis. NCI is always seeking talent and although this position is contingent upon an open position, we encourage you to apply. For this position, NCI will only employ those who are legally authorized to work in the United States without visa sponsorship.

Highlights of Responsibilities:

. Work with management, investigators, and analysts to provide reactive and proactive case development support and to fulfill law enforcement data requests.

. Communicate effectively with internal and external customers, including federal law enforcement officers.

. Validate data analysis results and analytically identifies potential fraud, waste and/or abuse situations in violation of Medicare/Medicaid laws, guidelines, policies, and regulations.

. Support management requests for CMS reporting requirements.

. Utilize data analysis tools and techniques to detect aberrancies in Medicare/Medicaid/Medi-Medi claims data and proactively seek out and develop leads and cases received from a variety of sources including CMS and OIG, fraud alerts, and referrals from government and private sources.

. Work with Statisticians and Sr. Data Analysts to perform statistical sampling and extrapolations in support of program integrity investigations; to provide proactive data analysis results with statistically high probabilities of producing identification of program vulnerabilities, case referrals to law enforcement, overpayments, and/or administrative actions.

. Prepare, develop and participate in provider, beneficiary, law enforcement, or staff training as related to fraud, waste and/or abuse data analysis within and across Medicare and Medicaid programs.

. Maintain chain of custody on all documents and follow all confidentiality and security guidelines.

. Comply with and maintain various documentation and other reporting requirements as needed.


. Proficiency with Microsoft Office applications, especially MS Word and MS Excel, at an advanced level.

. Working knowledge of SAS and/or other applications to perform various types of data analysis.

. Previous experience in data analysis as well as demonstrated knowledge of health care and claims or a combination of education and equivalent work experience.

. Demonstrated knowledge of various database management systems in order to input, extract or manipulate information

. Associate must have and maintain a valid driver's license issued by his/her state of residence.

Preferred Education and Experience:

. Bachelors or Masters degree in Statistics or related discipline.

. Knowledge of Medicare and Medicaid rules and regulations

. Demonstrated experience and knowledge of health care information (health claims data, ICD-9-CM codes, physician specialty codes, pharmaceutical data including NCPDP file formats and codes, provider identifiers, etc.)

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It is the policy of NCI to provide equal opportunity in recruiting, hiring, training, and promoting individuals in all job categories without regard to race, color, religion, national origin, gender, age, disability, genetic information, veteran status, sexual orientation, gender identity, or any other protected class or category as may be defined by federal, state, or local laws or regulations. In addition, we affirm that all compensation, benefits, company-sponsored training, educational assistance, social, and recreational programs are administered without regard to race, color, religion, national origin, gender, age, disability, genetic information, veteran status, sexual orientation, or gender identity. It is our firm intent to support equal employment opportunity and affirmative action in keeping with applicable federal, state, and local laws and regulations.

The information above has been designed to indicate the general nature and level of work performed by employees within the classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of employees assigned to this position.

Posted by StartWire

Baton Rouge, Louisiana, United States of America
NCI Information Systems, Inc.
NCI Information Systems, Inc.
8/13/2017 6:57:04 AM

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