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Claims Data Analyst / Healthcare Data Engineer (1099)
PayCompetitive
LocationMaryland/New York
Employment typeFull-Time
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Job Description
- Req#: 25-00016
Employer Industry: Healthcare Analytics
Why consider this job opportunity:
- Short-term contract role with competitive compensation
- Opportunity to work remotely within the United States
- Engage in a significant healthcare project transitioning to a value-based reimbursement model
- Collaborate with a leader in healthcare provider network development
- Chance to enhance your skills in data transformation and modeling within the healthcare sector
What to Expect (Job Responsibilities):
- Support the transformation and validation of facility claims and reimbursement data from payer sources
- Standardize disparate data sources and formats to facilitate benchmark pricing and modeling workflows
- Identify and flag data quality issues that may impact financial modeling or contract scenario analysis
- Assist modeling consultants in accessing and preparing files for DRG, APC, and per diem rate calculations
- Build or optimize repeatable workflows for importing and validating large datasets using tools like Excel, SQL, Python, or Alteryx
What is Required (Qualifications):
- Minimum of 3 years of experience working with healthcare claims data (payer or provider side)
- Familiarity with institutional claim formats (UB-04, 837I) and reimbursement logic (DRG, APC, per diem)
- Proficiency in Excel, SQL, or other data transformation tools (e.g., Python, SAS, Alteryx)
- Experience supporting contracting, actuarial, payment integrity, or pricing teams
- Comfortable working independently in a fast-paced environment and communicating technical findings clearly
How to Stand Out (Preferred Qualifications):
- Experience with Medicaid health plans, ACO support organizations, or provider enablement firms
- Familiarity with value-based payment analytics or bundled payment reconciliation
- Previous roles in data engineering
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