Senior Healthcare Data Analyst

Job Summary

Leading the development of reimbursement and payment integrity concepts, the full-time Senior Healthcare Data Analyst will analyze claims data, identify payment errors, and collaborate with technical teams to implement solutions in a remote work environment.

Key responsibilities:

• Lead pre and post-pay claim reviews to identify inaccurate payments using reimbursement and contract expertise
• Analyze and interpret provider contracts to ensure payments align with negotiated terms and payer rules
• Collaborate with engineering and data science teams to translate reimbursement logic into analytical frameworks

Required qualifications:

• 5+ years of experience in healthcare data mining or claims editing on the provider, payer, or vendor side
• Deep understanding of provider contracts, reimbursement methodologies, and claims processing
• Strong knowledge of payment logic across CMS and commercial payers
• Proven ability to identify improper payment patterns and root causes
• Comfortable working collaboratively with technical teams to guide implementation of business logic