Healthcare Claims Analytics Senior Consultant Guidehouse · Arlington, VA Full-time · Remote $98,000-

Job Family : Management Consulting Travel Required : Up to 25% Clearance Required : Ability to Obtain Public Trust What You Will Do : Demonstrate working knowledge ofclaims datasetsandhealthcare reimbursementconcepts. Assist in gathering and interpretingbusiness and technical requirementsfor claims audits and post-payment analysis. Conductdata-driven and qualitative researchto support payment policy evaluation and anomaly detection. Builddashboards and reportsusing coding tools to visualize claims trends and audit findings. Research and summarizeindustry-standard coding rulesand contribute to reimbursement policy discussions. Document findings and support the development ofrecommendations and follow-up actions. Contribute to analytics that identifypayment trends,errors, andimproper payment risks. Stay informed onstate healthcare reform effortsand emerging policy changes. Translate research and claims review insights intobusiness requirementsfor analytics tools. Respond to inquiries and disputes related toclaims editsandpolicy interpretation. Collaborate with internal teams and external stakeholders to support project delivery. Support project management activities and contribute to client interactions. What You Will Need : Bachelor's degree. At least3+ years of professional experience, including1+ year working with datasets to derive insights and solve problems and 1+ year of experiencecollaborating with internal or external stakeholders. Technical coding proficiency (e.g., SQL, Python, R) and experience developing basic dashboards and data visualizations. Exposure tohealthcare data analyticsandclaims data. Strong attention to detail and ability to prepare high-quality deliverables. Interest instate health agencies,Medicare/Medicaid,VA, and healthcare reform. Ability to obtain a Public Trust Clearance. What Would Be Nice To Have : 4+ years of experiencein claims processing, medical coding, auditing, or healthcare operations. Familiarity withreimbursement methodologies,provider contracts, and claims resolution practices. Experience withPower BI, Tableau, or similar tools for advanced data visualization. Strong written and oral communication skills. Ability to manage tasks independently and contribute to project execution. While this role is available remotely, strong preference will be given to candidates local to the DMV area who are willing and able to work onsite 2-3 days/week in our Tysons office. The annual salary range for this position is $98,000.00-$163,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs. What We Offer : Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace. Medical, Rx, Dental & Vision Insurance Personal and Family Sick Time & Company Paid Holidays Position may be eligible for a discretionary variable incentive bonus Parental Leave and Adoption Assistance 401(k) Retirement Plan Basic Life & Supplemental Life Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts Short-Term & Long-Term Disability Student Loan PayDown Tuition Reimbursement, Personal Development & Learning Opportunities Skills Development & Certifications Employee Referral Program Corporate Sponsored Events & Community Outreach Emergency Back-Up Childcare Program Mobility Stipend About Guidehouse Guidehouse is an Equal Opportunity Employer-Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation. Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco. If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at View phone number on click.appcast.io or via email at View email address on click.appcast.io . All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation. All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or View email address on click.appcast.io . Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process. Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee. #J-18808-Ljbffr Emploive