Myers and Stauffer LC is a certified public accounting and health care reimbursement consulting firm, specializing in audit, accounting, data management and consulting services to government-sponsored health care programs (primarily state Medicaid agencies, and the federal Center for Medicare & Medicaid Services). We have 45 years of experience assisting our government clients with complex health care reimbursement and provider compliance issues, operate 20 offices and have over 900 associates nationwide.

At Myers and Stauffer, you will have a career that is rewarding while also supporting our state and federal government healthcare clients that focus on those in need. We are committed to providing our employees with professional growth and development opportunities, a diverse, dynamic, challenging work environment, and a strong and visionary leadership team.

What We Offer:

• Health, Dental, and Vision insurance along with other competitive employee benefits
• Vacation time, sick time, paid holidays, and two floating holidays
• Paid Parental Leave and available support resources
• 401K with company matching for eligible employees
• Tuition reimbursement, referral bonuses, paid volunteer community service time, mentor program, and a variety of other employee programs and perks
• A combination of technical and leadership development training at each career milestone
• Up to six counseling sessions per year for eligible employees through our Employee Assistance Program

The Healthcare Data Analyst will play a crucial role in our multi-disciplinary team, utilizing data analytics to identify potential fraud, waste, or abuse of Medicaid or other healthcare system funds. This position requires proficiency in SQL, as the analyst will be responsible for reviewing and analyzing provider claims to determine if overpayments or underpayments have occurred in accordance with applicable policies. Additionally, the analyst will perform reimbursement calculations to quantify mispayments and prepare necessary documentation and reports.

Essential Functions:

• Independently conduct complex analyses and audits related to Medicaid or other reimbursement-related engagements, with a focus on identifying fraud, waste, abuse, or misuse of funds.
• Develop and maintain a comprehensive understanding of Medicaid and/or other payer statutes, regulations, provider billing manuals, and healthcare reimbursement policies.
• Conduct research to determine the standards for billing and coding compliance with Medicaid or other government program regulations.
• Draft and issue notification letters to healthcare providers regarding identified overpayments or underpayments, ensuring clear and concise communication.
• Interpret and analyze healthcare data, including medical, financial, or other records, to identify inconsistencies, anomalies, abnormal billing patterns, and indicators of suspected fraud, waste, or abuse (e.g., services not rendered, up-coding, un-bundling, etc.).
• Prepare comprehensive reports summarizing findings and recommendations for corrective actions.
• Present findings to clients, effectively communicating complex data analysis in a clear and concise manner.
• Collaborate effectively with team members, providing mentorship, training, and assistance as needed.
• Maintain the security and confidentiality of all protected health information encountered during the performance of duties.
• Participate in client meetings and conference calls as required.
• Handle phone calls and emails from providers, addressing any questions or concerns.
• Evaluate business processes to identify opportunities for improvement.
• Perform additional responsibilities as assigned.

Requirements:

• Bachelor's degree in Health Information Administration, Health Informatics, Healthcare Management, Information Systems, Data Science, or a related field. A postgraduate degree in a related field is preferred.
• Preferred certifications: CFE, AHFI, CHDA, CPMA, RHIT, or RHIA.
• 1-2 years of experience in healthcare data analysis or a related field is preferred.
• SQL proficiency is required, preferably with experience in working with large healthcare datasets.
• Familiarity with statistical analysis techniques and data mining methodologies is preferred.
• Proficient use of Microsoft Office software (Excel, Word, PowerPoint, etc.).
• Organized and detail-oriented, with the ability to think independently and problem solve effectively.
• Demonstrated ability to communicate verbally and in writing with all levels of an organization, both internally and externally.
• Effective in multitasking, prioritization of assignments, and management of multiple deadlines.
• Ability to work in a team environment.
• Willingness to travel based on client and business needs (0-10% of the time).
• Must be able to travel based on client and business needs

The Team:Myers and Stauffer takes pride in the welcoming and collaborative culture we have throughout our offices. For this position, the employee will report to one of our Managers or Senior Managers on the BPI engagement team.

Work Style:Our general business hours are Monday through Friday 8am-5pm, but can vary based on business needs. Dependent on performance, our in-office associates are eligible for a hybrid work schedule after their initial 90-day training period. As a company, we are always willing to discuss potential flexibility that an employee may need to better suit their work-life wellbeing.

Typical Interview Process:

• Phone Screen with a Recruiter
• In person or remote interview with the hiring manager & team
• Hiring decision and job offer

We understand that changing or learning a new industry can discourage strong candidates from applying. Myers and Stauffer is committed to investing in your career development and providing the necessary resources to help you succeed. Please do not hesitate to apply, as you may be the right fit for this position or another position we have open.

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