p********a
发帖数: 5352 | 1 最近有同学来问如何准备HEALTHCARE CLAIMS相关面试的事，这里我稍微写一些，与大
家分享，不对的地方也请大家指正
1. 本行业一般都是一些医疗保险公司，疾病管理公司，医疗研究公司，医疗CONSULTING.一般都需要对CLAIMS DATA熟悉，有META DATA(OVER 1 MILLION RECORDS)的工作经验
2. 目前最好找工作的还是CRO。基本上市场上60%以上的工作都是CRO的工作。本行业的职位数可能和MARKETING，银行查不多。
3. 本行业一般招人都找QUANTITATIVE专业，如数学，统计，经济，CS。或MPH
4. 面试一般需要准备2方面，一方面是SAS SKILLS，可能会问到很多和CLAIMS相关的SAS问题，比方说MEMBERSHIP data join with claims data, how to rotate data, retain/first.var to look for needed service dates. 另一方面是CLAIMS KNOWLEDGE，比方说MEDICAL CODING LIKE CPT/ICD9 |
w*****e
发帖数: 806 | 2 3x a lot, Banzhu....
it really helps..
rotate data--> proc transpose??? |
w********e
发帖数: 944 | |
l*********s
发帖数: 5409 | |
p********a
发帖数: 5352 | 5 long to wide, wide to long
transpose or array
【在 w*****e 的大作中提到】
: 3x a lot, Banzhu....
: it really helps..
: rotate data--> proc transpose???
|
d*******o
发帖数: 493 | |
l******g
发帖数: 29 | |
d***e
发帖数: 1533 | |
h****n
发帖数: 18 | 9 I worked for Medicaid Claims processing and I knew all subsystems related to
claims. Before Interview, you need to know how many different types claim
have and how the claims are processed. For example, Inpatient Hospital will
price based on revenue code and provider rate, Physicial claim priced based
on procedure codes, etc. The statistics only is not enough. |
A*******s
发帖数: 3942 | 10 could u plz offer more details? i have two upcoming interviews about
healthcare claims analysis. many thanks....
to
will
based
【在 h****n 的大作中提到】
: I worked for Medicaid Claims processing and I knew all subsystems related to
: claims. Before Interview, you need to know how many different types claim
: have and how the claims are processed. For example, Inpatient Hospital will
: price based on revenue code and provider rate, Physicial claim priced based
: on procedure codes, etc. The statistics only is not enough.
|
|
|
w*****e
发帖数: 806 | 11 但是fresh master 怎么找呢？？
你说的这个，没有做过 data的压根不可能知道阿。。
to
will
based
【在 h****n 的大作中提到】
: I worked for Medicaid Claims processing and I knew all subsystems related to
: claims. Before Interview, you need to know how many different types claim
: have and how the claims are processed. For example, Inpatient Hospital will
: price based on revenue code and provider rate, Physicial claim priced based
: on procedure codes, etc. The statistics only is not enough.
|
h****n
发帖数: 18 | 12 It is really not easy to provide all information at one time. you can try
to search online first, if you have any questions, you can ask me.
【在 A*******s 的大作中提到】
: could u plz offer more details? i have two upcoming interviews about
: healthcare claims analysis. many thanks....
:
: to
: will
: based
|
b*******r
发帖数: 152 | 13 just curious- are these industry-wide standardized already, or potentially u
will have to deal with diff standards by diff insurers,hospitals...
to
will
based
【在 h****n 的大作中提到】
: I worked for Medicaid Claims processing and I knew all subsystems related to
: claims. Before Interview, you need to know how many different types claim
: have and how the claims are processed. For example, Inpatient Hospital will
: price based on revenue code and provider rate, Physicial claim priced based
: on procedure codes, etc. The statistics only is not enough.
|
p********a
发帖数: 5352 | 14 CPT/ICD9/NDC/REVENUE都是行业标准吧。
CPT一般是在PHYSICIAN或者OUTPATIENT CLAIMS
REVENUE只是在INPATEINT CLAIMS
NDC只是在PHARMACY CLAIMS
不同的SETTING有不同的结构
不同的PRODUCT（COMMERCIAL，MEDICARE， MEDICAID）也有显著的差异。这些都是经验
积累出来的。入了行你会觉得挺简单的 |
y******0
发帖数: 401 | 15 Most of inpatient Claims are paid by DRG (Diagnosis related group) in
Medicare/Medicaid. Some may be paid by per diem.
【在 p********a 的大作中提到】
: CPT/ICD9/NDC/REVENUE都是行业标准吧。
: CPT一般是在PHYSICIAN或者OUTPATIENT CLAIMS
: REVENUE只是在INPATEINT CLAIMS
: NDC只是在PHARMACY CLAIMS
: 不同的SETTING有不同的结构
: 不同的PRODUCT（COMMERCIAL，MEDICARE， MEDICAID）也有显著的差异。这些都是经验
: 积累出来的。入了行你会觉得挺简单的
|
y******0
发帖数: 401 | 16 If you are interesting in Electronic data interchange (EDI), you may learn
some 837p and 837i. 837 EDI claims data are 行业标准. |
