Senior Claims Data Analyst

Centivo•Buffalo, NY

62d•Remote

About The Position

We exist for workers and their employers -- who are the backbone of our economy. That is where Centivo comes in -- our mission is to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills. Summary of the Role: The Senior Claims Data Analyst will play a pivotal role in enhancing the efficiency and scalability of our claims operation. This individual will drive insights through advanced analytics and develop high-impact reporting and dashboards. Partnering closely with the claims operations team, the analyst will identify opportunities for process improvement and own the analytics that empower our operations and leadership teams to succeed. This individual will go beyond surface-level reporting to identify patterns, uncover root causes, and drive strategic improvements that enhance operational efficiency, service delivery, and customer satisfaction.

Requirements

Proficiency in SQL with the ability to write complex queries and manipulate large datasets.
Strong skills in Python or R for data analysis and insight generation.
Strong skills in building interactive dashboards using Tableau, Power BI, or equivalent tools.
Familiarity with data warehousing and cloud platforms (e.g., AWS, Snowflake).
Exceptional attention to detail and commitment to data accuracy.
Critical thinking and structured problem-solving abilities.
Strong interpersonal skills for effective collaboration across operations, IT, and business teams.
Excellent verbal and written communication skills, with the ability to translate technical findings into business-friendly language.
Bachelor’s degree in Data Science, Statistics, Healthcare Administration, or a related field.
5 years of experience in data analytics, preferably within healthcare or insurance claims operations.
5 years of experience in healthcare, claims processing, stop loss reporting and data needs and relevant regulations (e.g., ACA, HIPAA).

Responsibilities

Collaborate with claims and stop loss operations teams to understand analytics and reporting needs that drive efficiency and scalability.
Scope, gather, and structure requirements into actionable opportunities and solutions.
Extract, manipulate, and analyze large datasets from claims databases using SQL or similar querying languages.
Translate data into actionable insights and strategic recommendations that inform process improvements, resourcing decisions, and operational priorities
Develop models and algorithms to identify trends, anomalies, root causes of inefficiencies and areas for operational improvement.
Design and maintain scalable dashboards and reports using tools like Tableau, Power BI, or similar platforms.
Create and monitor productivity and performance metrics to assess and enhance departmental efficiency.
Present findings to operations leadership with clear narratives that tie analytics to business outcomes.
Serve as a technical liaison between claims operations and the core data team to ensure accuracy and quality in analytics.
Develop and maintain SLA reporting to ensure claims operations meet and exceed client expectations.
Proactively identify and recommend areas for automation, workflow enhancements, and optimization across the claims lifecycle.
Ensure data integrity and accuracy across all analyses.