Note: The job is a remote job and is open to candidates in USA. Healthcare Horizons is a healthcare audit and advisory firm focused on protecting the financial health of benefit plans through claims analysis, audit, and technology-enabled payment error recovery. The Business Analyst will analyze large medical claims datasets, apply claims selection methodologies to identify likely payment errors, and communicate findings to auditors, leadership, and clients.
Responsibilities
- Ingest, clean, validate, and manipulate large medical claims datasets from carriers, TPAs, and clients, ensuring data completeness and integrity before analysis
- Learn and apply Healthcare Horizons’ claims selection methodologies to identify claims with the highest likelihood of payment errors for audit
- Analyze claims data for patterns, anomalies, duplicates, and outliers — and investigate the “why” behind what the data shows
- Develop clear summaries, visualizations, and reports that tell the story of the data for auditors, leadership, and clients
- Partner with auditors throughout the audit lifecycle, refining claim selections based on audit findings and feedback
- Participate in client and audit team discussions, presenting analytical findings and answering questions with clarity and confidence
- Document analysis logic, selection criteria, and data workflows so methods are repeatable and defensible
- Contribute ideas to improve selection algorithms, analytical tooling, and data processes as our technology evolves
Skills
- 2+ years of experience in data analysis, business analysis, or a similar analytical role working with large datasets
- Strong proficiency in Excel and SQL (SSMS, SSIS, SSRS); experience with Snowflake and Sigma (or similar Business Intelligence/Analyst tools) is a plus
- Experienced with modern ETL pipelines, Python (or similar) scripting, and core ML/data science concepts
- Demonstrated ability to draw conclusions from data, form and test hypotheses, and communicate the story behind the numbers
- Excellent verbal and written communication skills, with the ability to explain technical findings to non-technical audiences, including auditors and clients
- High attention to detail and a natural curiosity for investigating anomalies rather than just reporting them
- Ability to manage multiple projects and deadlines with accuracy and ownership
- Healthcare, medical claims, or benefits experience is helpful but not required — we will train the right candidate
- Bachelor's degree in an analytical field (e.g., data analytics, statistics, mathematics, economics, finance, or related) or equivalent practical experience
- The position is a fully remote role with the expectation to work from home. The incumbent would need to travel to our company meetings and events on a periodic basis
- Experience with Snowflake and Sigma (or similar Business Intelligence/Analyst tools)
- Healthcare, medical claims, or benefits experience
Benefits
- Bonus Plan
- Comprehensive health and wellness benefits package
- Retirement savings plan
- Opportunities for professional development and advancement
- Positive and collaborative work environment
Company Overview