ELIGIBILITY AND ACCUMULATOR ANALYST

Svitla Systems, Inc.; Bethlehem (Northampton County); On-site; USD 75,000 - 110,000; Full time

Benefits offered by this job

Christmas Bonus 50%

Employee referral bonuses

Learning & development program

Tech webinars and meetups

Job summary

Svitla Systems, Inc. is seeking an Eligibility and Accumulator Analyst to join our production support team in the healthcare data space. You will ensure data integrity for files received and sent, respond to incidents, and help expand automated monitoring while performing thorough manual checks.

The role emphasizes data analysis, SQL skills, and experience with eligibility structures and accumulators. Strong communication and collaboration are essential for rapid issue resolution and process

Qualifications

• Healthcare experience in data processing, eligibility, or claims
• Bachelor's degree in CS/IT or related field
• Proficient in SQL (moderate to advanced)
• Familiarity with reviewing complex Python notebooks
• Strong data analysis and problem-solving skills
• Experience with regulated data (GDPR, HIPAA, PHI, PII) and data controls

Responsibilities

• Process and analyze data, monitor file receipt and outbound generation
• Provide technical support and troubleshoot product-related issues
• Run SQL queries to manipulate data in relational databases
• Analyze large data sets to identify trends and root causes
• Document data processing workflows and analysis procedures
• Support testing of new configurations and incident resolutions

Skills

SQL

Python notebooks

Data analysis

Communication & teamwork

Problem solving

Education

Bachelor's degree in Computer Science/Information Technology or related field

Tools

Relational databases

Job description

Our client is a pharmacy company that uses AI-powered health analytics.

You will join the production support side team, ensuring that the files they receive and send contain the correct data, responding to incidents, eligibility issues, and issues related to accumulators. The client wants to expand the monitoring capability to automate it, but they still need personnel to physically check and ensure everything is working correctly. As an Eligibility and Accumulator Analyst, you will play a crucial role in supporting our data team with various tasks related to data processing, analysis, and reporting. This position is ideal for a professional with a strong foundation in eligibility, accumulators, or claims as well as data analysis and ticket resolution.

Working hours: 12pm EST – 8pm EST, holidays and weekends are also covered, they will either have either day by day rotation (shifted working day, like for example Tuesday‑Saturday for some people and Wed‑Sunday for others) across the team or standard working schedule (M‑F) with additional day off after working weekend/holiday day.

Requirements

• Experience working in Healthcare domain is a must.
• Minimum 4 years of experience in a related field.
• Bachelor’s degree in Computer Science, Information Technology, or a related discipline
• Proficiency in SQL (Moderate to Advanced)
• Familiarity reviewing complex Python notebooks
• Strong Data analysis expertise required
• Familiarity with medical and pharmacy claims processing, eligibility structure, and accumulators required
• Experience with regulated data controls such as GDPR, HIPAA, PHI, PII, etc.
• Detail-oriented with a commitment to producing accurate and reliable results
• Effective communication skills and ability to work collaboratively in a team environment
• Strong analytical mindset and problem-solving skills, able to take initiative, find answers, able to dine into the cause and find solutions, make recommendations, dig for information
• Demonstrate critical thinking and time-management skills
• Proficiency in troubleshooting and resolving technical issues.

Responsibilities

• Data Processing and Analysis
• Provide technical support for customers, assisting with product-related issues, troubleshooting, and escalations
• Monitor file receipt, processing, and outbound generation
• Execute SQL queries to retrieve, update, and manipulate data within relational databases
• Analyze large sets of data to identify trends and root cause of issues
• Make recommendations on solutions and drive requirements to technical teams
• Ensure data is accurate, secure, and compliant with organizational guidelines and any applicable regulations
• Monitoring and Issue Management
• Monitor inbound and outbound file exchanges, data quality, and eligibility and accumulator performance for the vendors and clients you are assigned
• Proactively identify and assess issues, risks, and monitor for trends
• Create clear and concise documentation for data processing workflows, code, and analysis procedures
• Facilitate the escalation process when necessary, ensuring timely resolution of critical issues
• Drive analysis and assessment of issues to determine root cause
• Develop and implement mitigation plans in accordance with KPIs
• Conduct detailed root cause analysis across large data sets
• Document and track support cases in a knowledge management system for future reference
• Work closely with other team members to understand project requirements and deliver accurate results
• Actively participate in team meetings, providing input and ideas for process improvement
• Develop solutions to issues proactively and comprehensively
• Ideate on proactive solutions to drive continuous improvement
• Identify improvement opportunities and work closely with internal teams to provide feedback for operational enhancements
• Support testing activities on new configurations.

We offer

• US and EU projects based on advanced technologies.
• Competitive compensation based on skills and experience.
• Regular performance appraisals to support your growth.
• Christmas Bonus in the amount of 50% of the monthly payment.
• Bonuses for recommendations of new employees.
• Bonuses for article writing, public talks, other activities.
• Personalized learning program tailored to your interests and skill development.
• Free tech webinars and meetups organized by Svitla.
• Fun corporate online/offline celebrations and activities.
• Awesome team, friendly and supportive community!