Senior Health Care Analyst (Audit & Data)

Job Description



Essential Functions And Primary Duties

• Develop an in-depth understanding of Medicaid and other payer regulations, including billing manuals and reimbursement policies. Conduct research to ensure compliance with billing and coding standards.
• Conduct audits related to Medicaid and healthcare reimbursement, focusing on the identification of fraud, waste, and abuse. Present well-researched and documented findings to clients.
• Use SQL to independently review and analyze large datasets of healthcare provider claims. Identify complex patterns of overpayments, underpayments, or fraud in accordance with applicable healthcare policies.
• Draft thorough and detailed reports and provider notification letters based on your data analysis, outlining key findings and recommendations for corrective actions.
• Collaborate closely with managers and clients to execute data-driven projects. Take ownership of key project tasks, manage timelines, and ensure deliverables are completed with a high degree of accuracy and professionalism.
• Participate in client meetings. Engage with clients and providers to explain findings and recommendations in a professional manner. Handle questions about project results or data and communicate effectively to maintain strong client relationships.
• Work alongside and mentor junior staff members by sharing best practices in data analysis and project management, while maintaining high standards of accuracy and confidentiality.
• Additional responsibilities as assigned
  
  

Preferred Qualifications

• Master’s degree in Health Information Administration, Health Informatics, Healthcare Management, Data Science, or related field
• SQL proficiency is strongly preferred, with experience in working with large healthcare datasets.
• 3-5 years of experience in healthcare data analysis, project execution, or related fields.
• Strong written and verbal communication skills, with experience in client-facing roles and report writing.
• Organized, detail-oriented, and able to independently manage multiple projects and deadlines.
• Knowledge of healthcare data privacy regulations.
• Certifications such as CFE, AHFI, CHDA, CPMA, RHIT, or RHIA.
• Experience in data mining, statistical analysis, or fraud detection methodologies.
• Experience working with Medicaid or other government healthcare programs.
  
  

Minimum Qualifications

• Bachelor's degree in accounting or related field required
  
  

About Us

Myers and Stauffer LC is a certified public accounting and health and human services 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 21 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 health and human service 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. Our firm takes pride in the welcoming and collaborative culture we have throughout our offices. We are always willing to discuss potential flexibility that an employee may need to better suit their work-life wellbeing.

What We Offer

• Health, Dental, and Vision insurance along with other competitive employee benefits for eligible associates
• Vacation time, sick time, and paid 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
  
  

We understand that changing or learning a new industry can discourage strong candidates from applying. Please do not hesitate to apply, as you may be the right fit for this position or another position we have open.