Senior Data Analyst (Healthcare Claims)

TL;DR

Senior Data Analyst (Healthcare Claims): Plans, conducts, and directs analysis of healthcare claims data for pre-sale evaluation, editing optimization, and ad hoc reporting with an accent on claims auditing, adjudication process improvement, and savings opportunities. Focus on designing and executing complex analyses using Excel and SQL, presenting actionable findings to clients, and managing portfolios of analytic engagements.

Location: Remote (US) – must be legally authorized to work in the U.S. No visa sponsorship or immigration support.

Salary: $104,368 - $156,551 (US base, full-time)

Company

AI-first healthcare technology platform preventing inaccurate payments and reducing waste in the healthcare ecosystem, with 35 years of pre-pay editing expertise.

What you will do

• Design and execute claims editing solutions, recurring reports, product optimization, and savings analyses in collaboration with clients, analytics, product, sales, and services teams.
• Facilitate analytic engagements including data diagnostics, mapping, edit analysis with Excel/SQL, and presentations with PowerPoint.
• Perform complex analyses to interpret findings, build customer solution roadmaps, and maximize value from the ClaimsXten product suite.
• Present findings to customers, handle follow-up analyses, and manage ongoing ad hoc requests for a portfolio of clients.
• Manage and prioritize multiple projects amid changing schedules, priorities, and workflows.

Requirements

• 6 years in healthcare claims operations, focused on claims auditing and adjudication process improvement.
• 2+ years knowledge of healthcare claims processing, managed care operations, and data attributes.
• 2+ years knowledge of healthcare claims coding including CPT/HCPCS and ICD-10.
• 2 years experience presenting to senior management internally and externally.
• Strong project management and organizational skills; ability to adapt quickly to business requirements.
• Bachelor’s degree required.
• Expert skills (2+ years) with MS Office: Excel, PowerPoint, Visio.

Nice to have

• Basic knowledge of SQL/PL-SQL for data manipulation.
• Experience designing and developing healthcare analyses.
• Understanding of claims editing software and systems like Facets, Amisys.
• Familiarity with ClaimsXten.
• Ability to learn and use new technologies.

Culture & Benefits

• Equal Opportunity Employer committed to an inclusive environment and collaborative success.
• HI-TRUST and SOC2 certified.
• Recognized as 2025 Best in KLAS for Pre-Payment Accuracy and Integrity, and 2025 CandE Award for Candidate Experience.