Sr. Data Analyst

About the Role

Key Responsibilities

• Writing SQL queries to extract data from the database, analysis of configuration data to identify clean-up activities.
• Ensure agreement configuration accuracy that may impact provider payment and member responsibility.
• Set up new Network and Agreement configurations into the Facets system.
• Validate agreement and network configuration utilizing claims testing, SQL queries, and Excel to ensure proper adjudication during claims processing.
• Perform and resolve network and agreement configuration questions/issues sent to the Business Configuration team without guidance.
• Maintain relationships with Account Managers and Provider teams to develop a cohesive cross-functional, results-driven working environment.
• Self-manage completion of work inventory within established quality and turnaround time guidelines.
• Coordinate and participate in cross-functional team activities for issue resolution.
• Recommend process and system enhancements to drive improvements.
• Support management with ongoing training activities, miscellaneous projects, resolving issues, and serving as a subject matter expert for all Configuration requests.

Requirements

• Bachelor's degree or equivalent experience.
• At least 5 years of experience working within a core claims administration system.
• A minimum of 2 years' experience writing SQL queries and exporting data from database tables.
• Good analytical and problem-solving skills.
• Good communication and interpersonal skills.
• Ability to work independently or as part of a team.
• Ability to manage multiple complex assignments simultaneously.

Nice to Have

• 3+ years' experience in Operations in the Healthcare industry.
• Experience understanding claim adjudication for member and provider reimbursements.
• Experience with Facets platform using Claims, Provider, Network, and Product Benefit Configuration.
• Knowledge of Medicare and Medicaid programs.
• SQL and Database experience.

Qualifications

• Educational background includes a Bachelor's degree or equivalent experience.

Benefits & Perks

• Comprehensive benefits package.
• Pay rate of $40/hr on W2.
• Work in a hybrid office environment.