Senior Claims Data Analyst

Proficiency in SQL with the ability to write complex queries. Strong skills in Python or R for data analysis. 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. Excellent verbal and written communication skills. 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).

Collaborate with claims and stop loss operations teams to understand analytics and reporting needs. Scope, gather, and structure requirements into actionable opportunities and solutions. Extract, manipulate, and analyze large datasets from claims databases using SQL. Translate data into actionable insights and strategic recommendations. Develop models and algorithms to identify trends, anomalies, and root causes of inefficiencies. Design and maintain scalable dashboards and reports using Tableau, Power BI, or similar platforms. Create and monitor productivity and performance metrics. Present findings to operations leadership with clear narratives. Serve as a technical liaison between claims operations and the core data team. Develop and maintain SLA reporting. Proactively identify and recommend areas for automation and optimization. Ensure data integrity and accuracy across all analyses.