Healthcare Claims Data Analyst

Universal Technologies•Albany, NY

2d•Hybrid

About The Position

UNIVERSAL Technologies, LLC is seeking an experienced Healthcare Claims Data Analyst for a hybrid role (as needed) in Albany, NY to provide quality assurance testing and analytical support for hospital and healthcare claims data across multiple payer types. Active LinkedIn preferred. The ideal candidate will have strong SQL expertise, healthcare claims experience, and the ability to analyze large datasets while validating data completeness and compliance with established business and program rules. Onsite work is typically 1-2 times per month but can vary. Multiple year project.

Requirements

Bachelor's Degree in a technical, scientific, or related field.
Minimum of 6 years of relevant professional experience.
Relevant healthcare industry experience is required.
High proficiency in SQL.
Strong understanding of relational database principles.
Experience analyzing large datasets, preferably within a healthcare environment.
Experience working with healthcare claims data.
Proficiency with Microsoft Office.
Strong documentation skills.
Strong critical thinking, problem-solving, and analytical skills.
Strong communication skills with the ability to clearly document and communicate findings.
Ability to work independently while contributing effectively within a collaborative team environment.
Ability to build effective relationships with team members, stakeholders, colleagues, and clients.
Strong collaboration skills and a customer-focused approach.
Ability to manage assigned deadlines and proactively communicate when timelines or deliverables may be at risk.

Nice To Haves

Active LinkedIn preferred.
A graduate degree in Health Informatics, Public Health, Statistics, Computer Science, or a related field may qualify toward relevant experience.
An equivalent combination of advanced education, training, and professional experience will be considered.
Experience with claims data across multiple Lines of Business (LOB) is preferred.
Experience with Extract, Transform, and Load (ETL) processes is preferred.
Knowledge of Master Data Management (MDM) concepts is preferred.
Experience or familiarity with ANSI EDI X12 healthcare transaction sets is preferred.
Experience or familiarity with NCPDP transaction sets is preferred.

Responsibilities

Provide quality assurance testing and analytical support to evaluate hospital data and healthcare claims from multiple payers, including Medicare, Medicaid, and commercial health plans.
Analyze healthcare data and claims to identify data quality issues, inconsistencies, and potential gaps.
Work closely with a SQL-proficient team to ensure data completeness and accuracy.
Verify that healthcare data meets applicable business and program rules based on vendor-provided technical documentation.
Perform data validation and quality assurance activities using SQL and other analytical methods.
Review and interpret technical documentation to understand data requirements, business rules, and validation criteria.
Work independently while contributing to solutions as part of a quality assurance and strategic advisory team.
Collaborate with team members, stakeholders, and clients to address data-related questions and resolve identified issues.
Maintain clear and accurate documentation of testing activities, findings, issues, and analytical results.
Complete assigned duties within established timelines.
Proactively communicate with the team leader when project timelines, assignments, or deliverables are at risk.