Claims Analyst

Managing multiple projects of various size and scope, the Claims Analyst will be responsible for data manipulation, analysis, and output to internal teams to help make decisions across all departments within the organization.

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Job Description

The Claims Analyst pulls, cleans, and analyzes healthcare and claims data to provide assessment and recommendations to help guide decision making throughout the organization. This data driven role, part of a key team, provide meaningful support to a number of areas including: health services and network management, and work in partnership with affordability initiatives to drive savings for members. The Claims Analyst will utilize a number of sources of information, applying data management, manipulation, aggregation, and statistical techniques to evaluate program effectiveness, identify success factors and improvement opportunities, suggest potential solutions, and help business owners set strategic directions.

Candidates must be self-starters, motivated to manage multiple projects of size and scope and have a curious mind to further dig into data, identify outliers, patterns, and trends and have the confidence to make recommendations. The ideal Claims Analyst will have previous experience with managed care, data warehouses, source systems, data management, and programming skills. All candidates must have worked with healthcare insurance claims data in the past.

 

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