Commure

Data Analyst, RCM Rules Engine

Commure

full-time

Posted on:

Origin:  • 🇧🇩 Bangladesh

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Job Level

Mid-LevelSenior

Tech Stack

PythonSQL

About the role

  • Conduct comprehensive QA testing on billing rules and logic within the RCM system to ensure compliance, accuracy, and efficiency.
  • Utilize advanced SQL techniques to extract, manipulate, and validate large datasets for rule testing and issue resolution.
  • Utilize Python to automate data processing, build models, and perform complex analyses; write reusable and efficient code.
  • Analyze billing transactions, rejections, and denials data to identify patterns, discrepancies, and areas for optimization.
  • Work closely with cross-functional teams to refine and enhance billing automation rules, ensuring alignment with industry best practices and compliance standards.
  • Develop and maintain detailed documentation of test cases, findings, and resolutions to support continuous process improvements.
  • Provide actionable insights and recommendations to optimize claim acceptance rates and streamline billing workflows.
  • Proactively identify system inefficiencies and collaborate with stakeholders to implement innovative solutions that drive operational excellence.
  • Night-shift duties (10:00 PM–7:00 AM, Monday–Friday) as part of regular responsibilities.

Requirements

  • Strong proficiency in SQL, including the ability to write complex queries, perform data validation, and debug issues – Must have.
  • Proficiency in Python for data processing and analysis.
  • Experience with data cleaning, structuring, and transformation.
  • Ability to work with large datasets and handle complex queries.
  • Proven ability to manage time effectively and deliver high-quality work within tight deadlines in a fast-paced environment – Must have.
  • Strong problem-solving and analytical skills, with exceptional attention to detail.
  • Strong written and verbal communication skills.
  • Ability to thrive under pressure and efficiently handle multiple priorities.
  • Bachelor's degree in Computer Science, Information Systems, Data Science or a related field preferred.
  • Knowledge of healthcare billing compliance, regulatory standards, and industry best practices preferred.
  • Willingness to work night shift (10:00 PM to 7:00 AM, Monday to Friday).
  • Experience using tools like Retool and writing reusable, efficient code.
  • Certifications in Advanced SQL or related database technologies (preferred/asked in application form).