Claims Data Research Analyst

Everest Group•Warren, NJ

2d•Hybrid

About The Position

The Claims Data Research Analyst analyzes claims data, identifies trends, investigates discrepancies, and provides actionable insights to support claims operations, underwriting, finance, and executive leadership. The role combines data analysis, reporting, and research to improve data quality, operational efficiency, and business decision-making. It is a hybrid position based in Warren, New Jersey, with three days onsite and two remote.

Requirements

Bachelor's degree in Data Analytics, Business, Finance, Mathematics, Statistics, Information Systems, or a related field.
2–5 years of experience in claims operations, insurance analytics, or data analysis.
Strong proficiency in Microsoft Excel, SQL, Python, and Power BI.
Experience working with large datasets and relational databases.
Strong analytical and problem-solving skills.
Excellent written and verbal communication skills.

Nice To Haves

Experience with insurance claims data, TPAs, policy administration systems, or claim management platforms.
Knowledge of Property & Casualty insurance, workers' compensation, liability, or specialty claims.
Experience with Power Automate, SharePoint, DAX, and data modeling.
Familiarity with data governance and data quality frameworks.

Responsibilities

Analyze claims data from multiple systems to identify trends, patterns, and anomalies.
Develop and maintain dashboards, reports, and scorecards using tools such as Power BI, Excel, and SQL.
Monitor claims performance metrics, including claim volume, severity, closure rates, and cycle times.
Perform root cause analysis on data inconsistencies and reporting variances.
Research and investigate claim-level discrepancies across source systems.
Validate the accuracy and completeness of claims data received from internal and external partners.
Reconcile claims information between claims management systems, TPAs, financial systems, and reporting databases.
Identify missing, duplicate, or inaccurate records to support data quality initiatives.
Partner with Claims, Finance, IT, Underwriting, and external TPAs to resolve data-related issues.
Support audits, regulatory reporting, and management information requests.
Document data definitions, business rules, and reporting processes.
Assist in developing controls to improve data integrity and reporting accuracy.
Identify opportunities to improve claims processes through data-driven recommendations.
Conduct ad hoc analysis to support strategic initiatives and operational decisions.
Present findings and recommendations to management clearly and concisely.
Support predictive analytics and trend analysis initiatives where applicable.
Leverage AI and emerging technologies to improve claims processes, efficiency, informed decision-making, and customer outcomes.