Impact You'll Make- Develop and maintain accurate audit tools and pricing calculators that support Stout's healthcare consulting and dispute engagements.
- Provide reliable analyses of healthcare pricing, reimbursement, payment activity, and future medical expenses for project teams and expert witnesses.
- Turn complex data and source documents into clear, reproducible calculations, exhibits, and reports.
- Improve analytical efficiency through current reference libraries, documented methodologies, and practical automation.
What You'll Do- Build, maintain, and update audit-tool templates, pricing calculators, and case-specific workbooks to reflect regulatory changes, new publications, data releases, and project needs.
- Perform commercial, Medicare, and Medicaid pricing analyses and fee schedule calculations; clearly explain assumptions, methods, and results.
- Conduct pre- and post-audit pricing reviews, payment reconciliations, paid/unpaid claim analyses, and reviews of EOB/EOR information and PIP logs.
- Maintain and customize pre-built excel based audit tools, including workbooks, data tables, and calculations for individual cases.
- Develop analyses and rebuttal calculations related to future medical expenses when required by an engagement.
- Gather, extract, organize, and analyze data from external systems, source documents, productions, and Medicare Limited Data Set (LDS) files.
- Maintain essential reference libraries, including state pricing files, code descriptions, fee schedules, and related source documentation.
- Apply version control, documentation standards, and data integrity checks to keep analyses accurate, transparent, and reproducible.
- Build custom tools, calculators, and output formats for project teams and outside auditors, including physicians and nurse reviewers.
- Prepare pricing datasets, analytical tables, exhibits, models, report supplements, and summaries for expert reports and testimony.
- Proofread reports and math-check calculations; research applicable regulations, technical interpretations, and opposing analytical positions.
- Explain analytical methods and findings to project teams and expert witnesses and, when necessary, testify on data-driven analyses.
What You'll Bring- Experience in quantitative analysis involving healthcare pricing, medical claims, reimbursement, or payment data.
- Strong spreadsheet and analytical modeling skills, including experience building detailed workbooks, calculators, or audit tools.
- Knowledge of commercial, Medicare, and Medicaid fee schedules, pricing methodologies, and medical code descriptions.
- Ability to reconcile claims and payments, identify data discrepancies, and document clear, defensible calculations.
- Experience extracting, organizing, and validating source data and maintaining reference files and version-controlled documentation.
- Ability to research regulatory materials and translate technical findings into accurate exhibits, reports, and explanations.
- Sound judgment when handling confidential information, managing competing requests, and developing custom solutions for varied projects.
How You'll Thrive- Apply careful attention to detail, math-checking discipline, problem-solving, and sound judgment across multiple engagements.
- Communicate complex analyses clearly and work effectively with consultants, attorneys, expert witnesses, clinical reviewers, and other specialists.
- Take ownership of your work and embody Stout's core values: Positive and Team-Oriented, Accountable, Committed, Relationship-Focused, Super-Responsive, and Great Communicators while delivering Relentless Excellence®.
Why Stout?At Stout, we offer a comprehensive Total Rewards program with competitive compensation, benefits, and wellness options tailored to support employees at every stage of life.
We foster a culture of inclusion and respect, embracing diverse perspectives and experiences to drive innovation and success. Our leadership is committed to inclusion and belonging across the organization and in the communities we serve.
We invest in professional growth through ongoing training, mentorship, employee resource groups, and clear performance feedback, ensuring our employees are supported in achieving their career goals.
Stout provides flexible work schedules and a discretionary time off policy to promote work-life balance and help employees lead fulfilling lives.
Learn more about our benefits and commitment to your success.
https://www.stout.com/en/careers/benefits
The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements and criteria necessary to successfully perform the job.
