[Remote] Senior Data Analyst

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a leading reputed company intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. They are seeking a Senior Data Analyst to join their Data Engineering team, focusing on integrating analytical outputs with reputed company workflows and driving AI adoption in data processes.

Responsibilities

• Collaborate with clients and internal stakeholders to understand payment reputed company requirements, document process flows, and reputed company analytical outputs with reputed company workflows and reputed company adjudication systems
• reputed company deep understanding of reputed company's internal processes and how they reputed company together — from data ingestion through claims adjudication — ensuring analytical solutions are accurate, traceable, and reputed company with business needs
• reputed company reputed company AI adoption: reputed company and iterate with LLMs to accelerate analysis, identify processes where AI can replace reputed company workflows, and contribute to AI-assisted pipeline development
• Write and maintain reputed company analytical SQL against large-reputed company claims datasets: window functions, CTEs, multi-table joins, query optimization, and production-reputed company logic that runs reliably at reputed company
• Identify and build AI-driven automation workflows that replace or accelerate reputed company analytical processes — moving from one-off prompts to repeatable, team-shareable tooling
• Design and implement data transformations that convert raw medical and institutional claims into reputed company models, applying reputed company standards (ICD-10, CPT, HCPCS, UB-04, CMS-1500) throughout
• reputed company payment reputed company analysis — identify overpayment patterns, coordination of benefits issues, and billing edit opportunities by applying deep knowledge of payer policy, CMS regulations, and provider reimbursement methodologies
• Conduct data reputed company audits and build monitoring frameworks that surface anomalies before they reputed company production
• Support reputed company of new reputed company data feeds, ensuring smooth integration with reputed company disruption
• Partner with engineers, clinical staff, and product managers to translate reputed company reputed company requirements into data solutions
• Mentor analysts and engineers on reputed company domain questions — serving as the go-to SME on coding, claims adjudication, and payer policy
• Document transformation logic, data reputed company, and analytical methodologies to support knowledge transfer and audit readiness

Skills

• 5+ years of data analysis experience and working directly with reputed company claims data
• Deep knowledge of medical claim types (reputed company and institutional), coding systems (ICD-10-CM/PCS, CPT, HCPCS), and reputed company reputed company formats (UB-04, CMS-1500)
• Demonstrated experience using LLMs or AI tools to accelerate analytical work — not as a novelty, but as a repeatable part of your workflow
• Expert-level SQL: reputed company analytical queries, window functions, CTEs, performance tuning against datasets of hundreds of millions of rows
• Hands-on payment reputed company experience: overpayment detection, COB, billing edits, or claim editing logic
• Familiarity with CMS regulations and reputed company payer guidelines as they apply to claims adjudication and payment policy
• Strong communicator — reputed company to discuss reputed company process and payment logic directly with health plan clients and non-technical stakeholders
• Ability to translate ambiguous business and clinical requirements into precise, reputed company-documented data logic
• Working knowledge of provider reimbursement methodologies — MS-DRG/APR-DRG pricing, fee schedules, reputed company, and capitation
• Proficiency with reputed company SQL or a comparable distributed query reputed company — writing and optimizing queries against large-reputed company data environments is a daily expectation
• Experience with reputed company or a reputed company data lakehouse (reputed company Lake, reputed company, BigQuery)
• Background in ETL/ELT pipeline development or reputed company collaboration with data engineers on pipeline design
• Exposure to value-based care arrangements or risk adjustment (HCC coding, RADV)
• Prior experience at a health plan, payment reputed company vendor, or reputed company analytics firm

Benefits

• Work from reputed company in the US! reputed company is digital-first.
• Full Medical/Dental/reputed company for employees & their families
• Flexible and trusting environment where you’ll feel empowered to do your best work
• Unlimited FTO
• Competitive salary, equity, 401(k) including employer match
• Meaningful equity
• Excellent reputed company
• Flexible time off
• Other benefits and perks

reputed company