Note: The job is a remote job and is open to candidates in USA. Arkhya Tech. Inc. is seeking a Senior Data Analyst to support healthcare claims reconciliation initiatives. The role will define matching criteria between pre-service estimates and adjudicated claims, analyze claims processing data using Snowflake, and collaborate with business analytics teams to interpret data elements across UHC medical platforms.
Responsibilities
- Support the Reconciliation Hub effort to define matching criteria between pre-service member- or provider-facing estimates versus actual claims submitted and adjudicated
- Identify patterns across claims processing data
- Partner with a business analytics team to identify relevant tables and attributes, explain how to interpret key data elements, and support analysis related to claim estimate matching and claim processing
- Identifying patterns across all major UHC medical platforms, tracing how claims are received and modified from pre-adjudication through adjudication, and ultimately matching to an estimate
Skills
- Seeking a U.S.-based senior-level IT expert with general understanding of medical claim coding, billing and processing, and ideally experienced with UHC claim systems including CSP Facets, UNET, COSMOS, and USP
- The ideal candidate will have a strong understanding of membership and provider identifiers, as recognize key claim processing capabilities such as benefit determination, editing, prior authorization matching, documentation requests, contract-based pricing, accumulators, and payment batching
- This role requires a senior-level resource with Snowflake expertise and strong analytical skills to identify patterns across claims processing data
- 5+ years of experience as a data analyst in data warehousing and healthcare data
- 3+ years of UHG internal experience analyzing healthcare claims data (CSP Facets, UNET, COSMOS, and USP) from core UHG data assets (i.e. UDW)
- Familiarity with Snowflake from prior roles as a data analyst
- Strong analytical capabilities to identify patterns across claims processing data
- Excellent communication and collaboration skills
- Strong problem-solving and analytical skills
- Ability to work in a fast-paced, dynamic environment
- The candidate must be able to attend meetings between the hours of 8:00 a.m. to 5:00 p.m. ET
Benefits
- Remote work
- Contract position
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