The Role
The Data Scientist will analyze datasets, develop models to predict fraud, and contribute to R&D by utilizing advanced mathematical and machine learning techniques.
Summary Generated by Built In
Healthcare Fraud Shield is looking for a Data Scientist to join the team.
Key Responsibilities
- Provide technical contributions in a fast-paced R&D team environment to accelerate our efforts on building new analytics.
- Utilize advanced mathematical models, machine learning algorithms, operations research techniques, and strong business acumen to deliver insight, recommendations, and solutions.
- Analyze data sets and develop models to predict fraud, waste, and abuse.
- Document and present results to internal team members for development and inclusion in company products and analysis.
- Satisfies all applicable requirements imposed by applicable Company customers, clients, or business partners, with respect to the relationship and role.
- Understands and complies with all company Privacy and Security standards.
- This job requires access to confidential and sensitive information, requiring ongoing discretion and secure information management.
Skills, Knowledge and Expertise
- Strong in mathematics and statistics
- Experience coding and modeling using Python
- Experience with SQL
- Strong language skills, with the ability to develop and implement natural language prompts for prompt engineering applications
- Strong business aptitude, the ability to rapidly learn new problem domains, and become conversant in the subject matter with team members
Benefits
- Medical, Dental & Vision insurance
- 401(k) retirement savings with employer match vesting immediately
- Vacation and sick paid time off
- 7 paid holidays & 2 floating holidays
- Paid maternity/paternity leave
- Disability & Life insurance
- Flexible Spending Account (FSA)
- Employee Assistance Program (EAP)
- Free on-site fitness center
- Professional and career development initiatives
- Remote work eligible
REMOTE WORK REQUIREMENTS:
- Must have high speed Internet (satellite is not allowed for this role) with a minimum speed of 25mbs download and 5mbs upload.
Healthcare Fraud Shield is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law
About
Healthcare Fraud Shield, headquartered in Chesterfield, MO, is a leading provider of innovative fraud, waste, and abuse (FWA) solutions for healthcare insurance payers. Since its establishment in 2011, the company has focused solely on healthcare fraud prevention and payment integrity, delivering unique advantages to its broad client base. At the heart of Healthcare Fraud Shield's offerings is FWAShield™, an integrated platform designed by industry-leading healthcare experts. This comprehensive solution includes PreShield™ (pre-payment), PostShield™ (post-payment), RxShield™ (pharmacy analytics), CaseShield™ (case management), and QueryShield™ (ad-hoc querying tool). Leveraging the latest technology available, Healthcare Fraud Shield provides the most affordable, flexible, transparent, efficient, and effective solution in the marketplace. With over 20 years of experience, the founders of Healthcare Fraud Shield are pioneers in successful fraud detection software development in the financial services industry. They have designed their suite of software to identify superior FWA rates, utilizing advanced analytics, AI, and the best exterior data. Additionally, Healthcare Fraud Shield offers expert services in detecting and verifying suspected FWA billed services, including the development of claim edit rules. Their experienced SIU team, which includes Accredited Health Care Fraud Investigators and Certified Professional Coders, delivers top-notch training throughout the country. Trust Healthcare Fraud Shield to safeguard your healthcare insurance payments and ensure payment integrity.
Skills Required
- Strong in mathematics and statistics
- Experience coding and modeling using Python
- Experience with SQL
- Ability to develop and implement natural language prompts for applications
- Strong business aptitude with rapid learning of new domains
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The Company
What We Do
Healthcare Fraud Shield provides AI-powered SaaS solutions and dynamic software to detect and prevent healthcare fraud, waste, abuse, and error (FWAE) across the claims lifecycle.
