Healthcare Claims Data Analyst

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $93.9k - $154.2k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📉 Data Analyst

👻 Ghost score 1%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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EXL

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛡️ Insurance

📦 Logistics

💰 $2M Venture Round on 2015-01

Healthcare • Insurance • Logistics

EXL is a business consulting and services firm that focuses on leveraging data to enhance business operations and decision-making. With a strong emphasis on collaboration and adaptability, EXL partners with organizations to address their unique needs and culture while integrating data science and technology solutions. The company's areas of expertise include operations management, decision analytics, digital transformation, and various industries such as healthcare, finance, and insurance. EXL's mission is to help clients drive business evolution and maintain competitive advantage through tailored solutions and effective use of data.

📋 Description

• Evaluate trends in utilization of healthcare products and services using historical data • Retrieve, organize, and analyze medical health claims data to identify root causes • Pull and integrate data from disparate sources, including claims and membership/enrollment data • Perform quality assurance reviews on data and document findings • Interpret, analyze, and present key findings to internal teams and business partners • Conduct deal reviews and collaborate with appropriate stakeholders • Publish attribution status to required stakeholders • Research attribution-related issues and coordinate with stakeholders to resolve them • Provide user guides and maintain documentation on attribution methodology • Help develop tools for attribution quality and transparency • Serve as analytical, technical, and business co-lead • Code primarily in HIVE, SQL, and Python

🎯 Requirements

• Bachelor's degree or equivalent experience • 5-7 years of relevant hands-on data analysis experience • 5-7 years of relevant medical claim experience across Inpatient, Outpatient, SNF, ESRD, Rehab, Behavioral Health, Home Health, and PBM areas • Strong Healthcare Insurance data experience • Experience using business tools to query large datasets, e.g., SQL, SAS Enterprise Guide, Claris, Pareo, Optum • Good written and verbal communication skills • Ability to present information to technical and non-technical audiences • Ability to work with large data sets from multiple data sources • Experience working with Azure Databricks • Experience with development and/or knowledge of Claims Code Edits • Knowledge and experience across claims systems such as QNXT, Facets, and TOPS

🏖️ Benefits

• Exciting, fast-paced and innovative environment • Opportunity to work closely with experienced, world-class analytics consultants • Opportunities to learn multiple aspects of clients’ businesses • Training in analytics and leading analytical tools and techniques • Mentoring program with guidance and coaching from senior professionals • Growth and development opportunities • Remote work / work from home