About the Role
This role is responsible for analyzing healthcare claims and encounter data to ensure regulatory compliance, data accuracy, and operational efficiency. The analyst will work closely with cross-functional teams to identify data discrepancies, implement corrective actions, and support reporting initiatives.
Responsibilities
- Evaluate claims and encounter datasets for completeness and correctness
- Identify inconsistencies in healthcare data submissions and resolve issues
- Support compliance with federal and state reporting requirements
- Collaborate with technical teams to validate data pipelines
- Develop and maintain documentation for data processes and workflows
- Perform root cause analysis on data errors and recommend improvements
- Assist in audits and external reporting submissions
- Monitor data quality metrics and generate periodic reports
- Work with stakeholders to clarify data requirements
- Ensure timely processing and reconciliation of claims data
- Participate in testing for system updates and data integrations
- Translate business needs into technical data specifications
- Maintain up-to-date knowledge of healthcare regulations
- Support onboarding of new data partners and vendors
- Troubleshoot data-related issues escalated by internal teams
- Contribute to process automation initiatives for data validation
- Coordinate with external partners on data exchange standards
- Track and report on key performance indicators for data operations
- Facilitate training sessions for team members on data protocols
- Ensure adherence to data governance policies
- Optimize data workflows to improve turnaround time
- Validate encounter data against claims records for consistency
- Prepare summaries for leadership on data quality trends
- Engage in continuous improvement of data management practices
- Respond to data inquiries from compliance and operations teams
Compensation
Competitive salary and benefits package offered
Work Arrangement
Hybrid work model with flexibility for remote and office-based work
Team
Collaborative team environment focused on data accuracy and healthcare analytics
Why This Role Matters
Accurate claims and encounter data are essential for regulatory compliance and financial reporting. This role directly impacts data reliability and helps ensure organizational success in a highly regulated environment.
Growth Opportunities
Analysts have access to professional development resources, mentorship programs, and opportunities to lead process improvement initiatives within the data team.
Visa sponsorship may be available for qualified candidates
