Healthcare Quality Assurance Analyst

Garnet River LLC•Albany, NY

1d•$110,000 - $160,000•Hybrid

About The Position

We are currently seeking a Claims Data Analyst for our client in Albany, NY. In this role, you will provide quality assurance testing and analytical support to evaluate hospital data and healthcare claims from multiple payers, including Medicare, Medicaid, and commercial plans. Working closely with a SQL-proficient team, you will help ensure data completeness and verify that business and program rules are met according to vendor-provided technical documentation. In this consulting role, you will work independently while contributing to solutions as part of a quality assurance and strategic advisory team. Success in this position requires strong communication, documentation, critical thinking, and analytical skills, along with the ability to build effective relationships with colleagues and clients through collaboration and a customer-focused approach. You must complete assigned duties on time and proactively manage expectations with the team leader when timelines or deliverables are at risk. This is a hybrid position that requires an onsite presence in Albany, NY one to two days per month.

Requirements

Highly proficient in SQL
Understand relational database principles
Experience analyzing large data sets, preferably in healthcare
Proficiency with Microsoft Office
Strong documentation, critical thinking, problem-solving, and analytical skills
Ability to build effective relationships with team members and stakeholders
Ability to build effective relationships with colleagues and clients through collaboration and a customer-focused approach
Bachelor's Degree in a technical, scientific, or related field
6 years of relevant experience
Relevant healthcare industry experience required
An equivalent combination of advanced education, training, and experience will be considered

Nice To Haves

Experience with claims data across multiple Lines of Business (LOB)
Extract, Transform, and Load (ETL) processes
Master Data Management (MDM) concepts
ANSI EDI X12 healthcare transaction sets
NCPDP transaction sets

Responsibilities

Provide quality assurance testing and analytical support to evaluate hospital data and healthcare claims from multiple payers, including Medicare, Medicaid, and commercial plans.
Working closely with a SQL-proficient team, help ensure data completeness and verify that business and program rules are met according to vendor-provided technical documentation.
Work independently while contributing to solutions as part of a quality assurance and strategic advisory team.
Complete assigned duties on time and proactively manage expectations with the team leader when timelines or deliverables are at risk.