Salary: $80,000 – $105,000 per annum
About the Role:
Are you an experienced Data Integration Specialist with a knack for healthcare data analysis? We are seeking a detail-oriented professional to join our team, focusing on the analysis, development, and enhancement of claim batch file and real-time data integration interfaces. As a subject matter expert, you will use your technical expertise and business insight to provide critical support to both internal and external customers, conduct thorough claims analysis, and generate ad-hoc reports.
Key Responsibilities:
Data Integration: Identify and define data requirements for new sources. Perform technical analytics to ensure data integration meets or exceeds expectations. Develop and refine user interfaces and layouts.
Process Improvement: Evaluate current processes to identify opportunities for increased effectiveness, reduced risks, and cost savings. Assist in creating processes and architectures to integrate healthcare claims data and promote data integration best practices.
Analysis & Reporting: Conduct detailed claims analysis and produce accurate ad-hoc reports based on verbal and written requests. Provide insights and recommendations to stakeholders.
Collaboration: Work with internal leaders to understand objectives and contribute to the prioritization of initiatives. Communicate technical and analytic information clearly to business partners.
Quality & Efficiency: Actively engage in process improvement efforts. Develop dynamic data quality monitoring tools to identify defective data and resolve data issues efficiently.
Additional Responsibilities:
Ensure all work is of high quality and meets client needs.
Produce, validate, and deliver regular reports in a timely manner.
Set clear expectations with clients while maintaining professionalism and excellence.
Qualifications:
Education & Experience: Bachelor’s degree in a technical, computer science, or math discipline, with at least 3 years of relevant experience.
Technical Skills: 2+ years of experience with large volume medical claim files, data design, transformation, relational databases, and SQL (Oracle and ANSI preferred). Proficiency in Microsoft Office Suite (Outlook, Excel, Word), and experience with Java or similar programming languages.
Excel Proficiency: Advanced skills in Excel (Pivot Tables, Macros, V Lookups, advanced formulas, VBA).
Skills: Strong organizational abilities, attention to detail, and confidentiality. Excellent analytical, problem-solving, and communication skills. Ability to handle multiple tasks and meet deadlines both independently and within a team.
Preferred Skills:
Experience with Red Hat Decision Manager, Agile methodologies, and standard industry coding systems (CPT, ICD-10, HCFA-1500, UB04, X12, HL7).
Familiarity with XML, real-time processing systems, healthcare claims processing platforms, and editing systems.
Experience in a HIPAA-regulated environment is a plus.
Job Demands:
This role is fully remote but may require occasional travel for team collaboration and special projects.
Flexibility to participate in global conference calls, typically aligned with Eastern Time Zone hours.
Physical Requirements:
Ability to remain stationary for extended periods, including standing or sitting.
Repetitive motions involving wrists, hands, and fingers.
Must have a secure, dedicated workspace with high-speed internet connectivity.
Compensation & Benefits:
Base Salary: $80,000 – $105,000 annually, based on experience and qualifications.
Benefits: Competitive package including medical, dental, vision, disability, and life insurance. 401(k) plan with company match, paid family leave, 9 paid holidays, and 17-27 days of Paid Time Off (PTO) per year based on service length.
Application Details:
Cotiviti is an equal opportunity employer, committed to fostering a diverse and inclusive workplace. We encourage candidates from all backgrounds to apply.
