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Data Science Engineer
2 weeks ago
Location: Hyderabad
Unlocking digital performance. Delivering measurable results.
We are seeking a skilled and analytical Data Scientist to join our Physician RCM team. The ideal candidate will use advanced analytics, machine learning, and data engineering to identify trends in medical billing, optimize claims performance, predict denials, and support financial decision-making. You will collaborate with revenue cycle leaders, billing teams, and IT to improve overall reimbursement and reduce administrative burden.
- Analyze large volumes of claims, denials, payments, and EHR/billing data to identify trends and actionable insights.
- Develop and deploy machine learning models to predict claim denials, flag coding errors, and identify underpayments.
- Design dashboards and reporting tools for key RCM KPIs: Days in A/R, denial rate, clean claim rate, net collections, etc.
- Automate repetitive analytics processes and reports using Python/R, SQL, or other BI tools.
- Partner with billing/coding teams to interpret findings and recommend operational improvements.
- Evaluate payer behavior, identify reimbursement gaps, and support contract negotiations.
- Collaborate with IT to ensure data quality, pipeline integrity, and ETL automation.
- Work with finance teams to support forecasting and revenue optimization.
- Stay updated on regulatory changes (CMS, HIPAA, ICD/CPT changes) affecting RCM data.
- Bachelors or master's degree in data science, Computer Science, Statistics, Health Informatics, or related field.
- 2–5 years of hands-on experience in data science, preferably in a healthcare or RCM setting.
- Proficient in Python or R for data modeling, and SQL for data extraction and transformation.
- Experience with RCM platforms (e.g., Epic, Athena, AdvancedMD, GE CB , Modmed) is highly preferred.
- Familiarity with healthcare coding (ICD-10, CPT, HCPCS) and medical billing practices.
- Strong understanding of physician practice workflows and RCM lifecycle (pre-auth, charge capture, denial mgmt., etc.)
- Experience with Tableau, Power BI, or Looker for data visualization.
- Knowledge of machine learning algorithms (classification, regression, clustering) as applied to real-world healthcare datasets.
- Strong problem-solving and communication skills.