Senior Data Analyst – Healthcare Claims | Remote

Job Overview

We are seeking an experienced Senior Data Analyst to support the Reconciliation Hub initiative within a healthcare claims environment. The ideal candidate will have strong experience in healthcare data analytics, data warehousing, medical claims processing, and Snowflake, along with a solid understanding of healthcare membership, provider, billing, and claims data.

This role will focus on defining and analyzing matching criteria between pre-service member/provider estimates and actual claims that are submitted and adjudicated. The selected candidate will work closely with business analytics teams to identify relevant data sources, understand key data elements, analyze claims-processing patterns, and support the development of reconciliation capabilities across multiple healthcare lines of business.

Position Details

Job Title: Senior Data Analyst
Location: Remote
Job Type: Contract
Specialization: Healthcare Data / Claims Analytics / Snowflake / Data Warehousing
Experience: 5+ Years Data Analytics
Healthcare Experience: 5+ Years
Meeting Availability: 8:00 AM – 5:00 PM ET

Role Overview

The Senior Data Analyst will play a key role in understanding healthcare claims data and identifying patterns across the claims lifecycle.

The position requires someone who can analyze how claims are received, processed, modified, and adjudicated, and ultimately determine how those claims can be matched to previously generated estimates.

The analyst will collaborate with business analytics and technical teams to identify the appropriate tables and attributes, explain the meaning of important data elements, and provide analytical insights that support the Reconciliation Hub.

Key Responsibilities

• Analyze healthcare claims and data warehouse information to identify patterns and relationships.
• Support the definition of matching criteria between pre-service estimates and actual adjudicated claims.
• Identify relevant tables, fields, attributes, and data elements required for reconciliation analysis.
• Analyze claims from pre-adjudication through final adjudication.
• Trace how claims are received, processed, modified, and ultimately paid.
• Identify relationships between member, provider, estimate, and claim information.
• Work closely with business analytics teams to understand requirements and translate them into data analysis.
• Use analytical techniques to identify patterns, discrepancies, and relationships across claims processing data.
• Support the development and enhancement of the Reconciliation Hub across multiple lines of business.
• Explain healthcare data elements and their business meaning to technical and business stakeholders.
• Perform data validation and quality analysis.
• Investigate discrepancies between estimates and actual claims.
• Document findings, data relationships, business rules, and analytical results.
• Collaborate with cross-functional teams in a fast-paced healthcare technology environment.

Healthcare Claims Knowledge

Strong knowledge of healthcare claims processing is important for this role.

The candidate should understand concepts such as:

• Medical claim coding
• Healthcare billing
• Claim submission
• Claim adjudication
• Benefit determination
• Claim editing
• Prior authorization matching
• Documentation requests
• Contract-based pricing
• Accumulators
• Payment batching
• Member identifiers
• Provider identifiers
• Claim processing workflows

Understanding how claims move through different stages of the healthcare processing lifecycle will be critical to successfully performing this role.

UHG / Healthcare Platform Experience

Experience working with UnitedHealth Group (UHG) healthcare claims data is highly important.

Candidates should have experience analyzing healthcare claims data from platforms such as:

• CSP Facets
• UNET
• COSMOS
• USP
• UHG core data assets such as UDW

The ability to understand relationships between these platforms and healthcare claims data will be valuable when identifying patterns and developing reconciliation logic.

Snowflake & Data Warehousing

Strong experience with Snowflake is required.

The Senior Data Analyst will use Snowflake and enterprise data warehouse environments to:

• Query and analyze large healthcare datasets.
• Identify relevant tables and attributes.
• Validate claims and estimate data.
• Investigate data relationships.
• Identify patterns across claims processing.
• Support reconciliation and matching analysis.
• Perform data validation and quality checks.

Strong SQL and data analysis capabilities are expected when working with large healthcare datasets.

Required Qualifications

• 5+ years of experience as a Data Analyst.
• Strong experience with data warehousing and healthcare data.
• 3+ years of UHG internal experience analyzing healthcare claims data preferred/required.
• Experience with CSP Facets, UNET, COSMOS, and USP.
• Experience working with UHG core data assets such as UDW.
• Familiarity with Snowflake from previous data analyst roles.
• Strong analytical skills and ability to identify patterns across complex claims data.
• Understanding of healthcare claims processing and medical billing.
• Strong SQL/data analysis capabilities.
• Excellent communication and collaboration skills.
• Strong problem-solving and analytical abilities.
• Ability to work effectively in a fast-paced environment.
• U.S.-based candidate.

Ideal Candidate

The ideal candidate is a senior healthcare data analyst with strong experience analyzing claims and data warehouse information.

You should be able to understand complex healthcare data structures, identify relevant data elements, analyze claim-processing patterns, and explain findings clearly to both business and technical teams.

Experience with UHG claims platforms and internal healthcare data assets is particularly valuable for this position.

Work Arrangement

Location: Remote

The candidate must be available to attend meetings between:

8:00 AM – 5:00 PM ET

How to Apply

Qualified candidates with strong healthcare claims analytics, Snowflake, data warehousing, UHG claims systems, and data analysis experience are encouraged to submit their updated resume.

📩 Send Resume: rahul.pandey@quantumworldit.com

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