Decision Scientist

Fractal

Bengaluru, India
Claims adjudication and payment integrity
Genai and classical analytics application
Cloud and data platform exposure
Own end-to-end problem solving for claims operations to improve auto-adjudication, reduce rework and denials, and modernize integrations

Job Summary

  • Own end-to-end problem solving for claims operations to improve auto-adjudication, reduce rework and denials, and modernize integrations.
  • Partner with business, data, and engineering teams to deliver measurable gains in first-pass adjudication, throughput, and cost-per-claim.
  • If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!

Matching Summary

Own end-to-end problem solving for claims operations to improve auto-adjudication, reduce rework and denials, and modernize integrations.

Skills & Requirements

Must-have

  • Claims adjudication and payment integrity
  • GenAI and classical analytics application
  • Cloud and data platform exposure
  • Consulting and business analysis skills
  • HIPAA Privacy and Security compliance
  • EDI X12 and FHIR interface design

Nice-to-have

  • Experience with payment integrity and pricing engines
  • Exposure to BI tools like Power BI and Tableau
  • GenAI/RAG for claims documentation
  • Executive storytelling and workshop facilitation
  • Working in a passionate and customer-focused environment

Key Requirements

  • 6–10 years US healthcare consulting experience
  • Hands-on claims adjudication and care management
  • Working knowledge of HIPAA and PHI/PII handling
  • Experience with GenAI solutioning and analytics
  • Exposure to Azure/AWS/GCP and SQL/PySpark
  • Proposal and stakeholder management experience

Work Rights

Not specified

Tailored Resume

Cover Letter