Claims Data Analyst

Location: Albany Hybrid Onsite as needed - Typically onsite 1-2 times per month

Applicants must be currently authorized to work in the United States without the need for visa sponsorship now or in the future.

Description

As a Claims Data Analyst, you will provide quality assurance testing and analytical support to evaluate hospital data and healthcare claims from multiple payers, including Medicare, Medicaid, and commercial plans. Working closely with a SQL-proficient team, you will help ensure data completeness and verify that business and program rules are met according to vendor-provided technical documentation. In this consulting role, you will work independently while contributing to solutions as part of a quality assurance and strategic advisory team. Success in this position requires strong communication, documentation, critical thinking, and analytical skills, along with the ability to build effective relationships with colleagues and clients through collaboration and a customer-focused approach. You must complete assigned duties on time and proactively manage expectations with the team leader when timelines or deliverables are at risk.

Duties

• Provide quality assurance testing and analytical support to evaluate hospital data and healthcare claims from multiple payers, including Medicare, Medicaid, and commercial plans.
• Working closely with a SQL-proficient team, help ensure data completeness and verify that business and program rules are met according to vendor-provided technical documentation.
• Work independently while contributing to solutions as part of a quality assurance and strategic advisory team.
• Complete assigned duties on time and proactively manage expectations with the team leader when timelines or deliverables are at risk.

Mandatory Requirements

• Experience (12+ Years)

Requirements

• This is an 100% Onsite
• Bachelor's Degree in a technical, scientific, or related field.
• 6 years of relevant experience.
• Relevant healthcare industry experience required.
• A graduate degree in health informatics, public health, statistics, computer science, or a related field may also qualify as relevant experience.
• An equivalent combination of advanced education, training, and experience will be considered.
• Candidates must be highly proficient in SQL, understand relational database principles, and have experience analyzing large data sets, preferably in healthcare.
• Proficiency with Microsoft Office is required.
• Strong documentation, critical thinking, problem-solving, and analytical skills.
• The ability to build effective relationships with team members and stakeholders.
• Ability to build effective relationships with colleagues and clients through collaboration and a customer-focused approach.

Preferred Qualifications:

• Experience with claims data across multiple Lines of Business (LOB), Extract, Transform, and Load (ETL) processes, Master Data Management (MDM) concepts, ANSI EDI X12 healthcare transaction sets, and/or NCPDP transaction sets is preferred.