Analyze healthcare claims data to identify patterns, anomalies, and cost-saving opportunities.
Prepare detailed reports and dashboards for internal and client use.
Collaborate with cross-functional teams to implement data-driven solutions.
Ensure compliance with healthcare regulations and data privacy standards.
Support audits and quality assurance processes related to claims data

Bachelor’s degree in Healthcare Administration, Business, Accounting, Analytics, Public Health, or a related field preferred
Relevant experience working for a medical TPA or PBM either adjudicating or auditing claims may be considered in lieu or a bachelor’s degree.
1 year of experience in healthcare consulting, provider billing, insurance claims adjudication, or related area.
Familiarity with healthcare databases and systems.
Proficiency in Microsoft Office and data analysis tools.

Health Care Claims Analyst – Entry Level

Key skills