• Conduct thorough quality assessments of healthcare claims data, focusing on identifying overpayments through data mining techniques. • Develop, implement, and execute quality assurance plans and test cases specific to healthcare claims data mining. • Collaborate with data analysts and business partners to analyze claims data for potential overpayments and ensure compliance with client policies. • Identify and document any discrepancies or anomalies in claims data, coordinating with cross-functional teams for resolution. • Conduct root cause analysis on detected overpayments and develop reports summarizing findings and recommendations for process improvements. • Monitor and evaluate data mining processes, providing innovative solutions to enhance data accuracy and quality assurance in healthcare claims. • Prepare and present detailed quality assurance reports and metrics to stakeholders, highlighting trends and areas for improvement. • Foster strong working relationships with various business partners, ensuring effective communication and collaboration on claims data integrity initiatives.