BI Analyst (Healthcare)

Location: Remote Flex - North Carolina, United States

Salary: $89,174.00–$142,679.00 annually

Company

hirify.global provides health insurance and healthcare services, with this role supporting fraud detection, payment integrity, and claims analytics.

What you will do

• Partner with Special Investigations Unit, Payment Integrity, Clinical, Finance, and operational stakeholders to define needs and deliver analytical solutions.
• Build and maintain dashboards, scorecards, reports, and self-service analytics for investigations, provider risk, savings, recoveries, cost avoidance, and operational performance.
• Analyze healthcare claims, provider, member, audit, and investigation data to identify trends, anomalies, risks, and improvement opportunities.
• Develop recurring and ad hoc financial and operational reporting for leadership, including productivity, return on investment, resource utilization, and program effectiveness.
• Design, validate, and document statistically valid random sampling methodologies for provider audits, overpayment identification, error-rate measurement, and extrapolation.
• Communicate findings and recommendations, validate data accuracy, reconcile outputs, and maintain reporting standards and governance practices.

Requirements

• Bachelor’s degree or advanced degree; alternatively, 5+ years of related experience in lieu of a degree.
• 3+ years of experience in healthcare analytics, Special Investigations Unit, Payment Integrity, or a related field.
• Strong analytical, problem-solving, and communication skills.
• Experience analyzing healthcare claims and supporting fraud, waste and abuse, payment accuracy, auditing, or provider payment review functions is relevant to the role.

Nice to have

• Knowledge of healthcare claims processing, reimbursement methodologies, CPT, HCPCS, ICD-10, DRG, and provider billing practices.
• Experience with statistical sampling, confidence intervals, extrapolation, healthcare savings, recoveries, cost avoidance, and operational performance metrics.
• Experience with Snowflake.
• Experience building AI agents.

Culture & Benefits

• Remote-flex work arrangement based in North Carolina.
• Annual incentive bonus based on corporate goal achievement and individual performance.
• 401(k) with employer match.
• Paid time off, competitive health benefits, and wellness programs.
• Opportunity to collaborate with cross-functional healthcare, analytics, finance, and operational teams.