Qualifications: Education & Certification (one of the following required): • Bachelor’s or Master’s Degree in Computer Science, Data Science, Information Systems, or related field • Medical or Life Sciences background (MBBS, BDS, BPT, BAMS, Nursing, Pharmacy, Life Sciences) Certification Requirements: • Preferable • FHIR/HL7, EDI Certification Specialty Expertise: Candidates must have proficiency in the following areas: • Understanding of Revenue Cycle Management (RCM), US healthcare Claims & coding and billing. • Healthcare Claim Form (Professional - 1500), (Facility - 1450) and EDI maps for ANSI X12 transaction sets. • Medical Codes: CPT/HCPCS, ICD, DRG, Modifiers etc. • Provider Data: NPI, Taxonomy Codes across all providers. • Value sets: Standard value set in US healthcare. • Data Integrity Validation. • Data classification Metholodologies. • Preferable, Clinical Data Exchange – Understanding expertise in healthcare data exchange standards (HL7, FHIR,) and clinical terminologies (SNOMED, LOINC). Key Skills: • Data Integration & Data Mapping. • Healthcare Claims Data Analysis. • Payment Integrity and Claims Adjudication Domain Knowledge. • Knowledge of code sets: CPT, HCPCS, ICD, DRG, PCS, Modifiers. • Understanding of Healthcare Claim Form (Professional - 1500), (Facility - 1450) and EDI maps for ANSI X12 transaction sets. • Strong proficiency in SQL, Python (Preferable), Microsoft Excel and data analysis tools. • Strong analytical, critical thinking, and problem-solving skills. • Excellent written and verbal communication skills.