Insurance Claims Analyst

Shelby American, Inc.; Virginia; Remote; Full time

Job summary

A leading healthcare organization is seeking a skilled Data Analyst (Insurance Claims) to analyze complex claims data. This remote role requires expertise in data analysis and a passion for improving healthcare operations. The ideal candidate will work with cross-functional teams to drive insights and enhance patient outcomes.

Benefits

Medical Insurance

Vision Insurance

Life Insurance

Short- and Long-Term Disability

Critical Illness

Hospital Indemnity

Legal Assistance

Unlimited PTO

401k with company match

Qualifications

• Experience analyzing healthcare claims data.
• Ability to interpret complex claims data.

Responsibilities

• Analyze healthcare claims data to provide actionable insights.
• Develop data visualizations and dashboards for claims metrics.

Skills

Analytical Skills

Problem Solving

Communication

Data Privacy Knowledge

Education

Associates Degree

Bachelor's Degree

Tools

Excel

Job description

At Holon Health, we are dedicated to revolutionizing the way healthcare services are delivered. With a strong focus on community health, we strive to provide support and solutions that address the whole health needs of people with Substance Use Disorder (SUD). We help these individuals navigate chronic medical conditions, SUD, and Behavioral Health needs with a focus on prevention, integrative treatment, and recovery.

Holon Health’s initiatives develop, support, and maintain relationships with provider partners and community-based organizations to promote programs advocating long-term health and wellness for this complicated population. By acting as the first point of contact for the justice systems and programs with whom we partner, Holon Health provides timely and efficient brief interventions to better prepare clients to receive community-based services and engage in proactive, prosocial behaviors.

WHO WE ARE:

The Holon Health team member is a dynamic individual who possesses meticulous attention to detail and excels as a team player. They possess effective communication skills, along with grit, tenacity, and resilience to navigate challenges. Demonstrating compassion and empathy, they approach interactions with sincerity and understanding. Additionally, their ability to inject a touch of playfulness adds a unique and positive element to the workplace. They exhibit relentless curiosity to understand the why, never relying on the shortcut of assumptions. Guided by a strong moral compass, they consistently strive to bring the wow factor to every aspect of their work.

POSITION SUMMARY:

We are looking for a skilled Data Analyst (Insurance Claims) to join our dynamic team. You will be primarily responsible for analyzing complex healthcare claims data to provide actionable insights that drive business strategy, improve operational efficiency, and potentially enhance patient outcomes. You will work closely with cross-functional teams, including RCM and Practice Management, to identify opportunities, solve problems, and contribute to the overall success of Holon Health.

SCHEDULE & LOCATION

This is a full remote role, but the individual must be physically located in the United States. Hours will typically be 40 per week with some flexibility around when those hours occur.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Collect, clean, and process large volumes of healthcare claims data from various sources, ensuring data integrity and accuracy.
• Perform in-depth analysis of claims data to identify trends, patterns, and anomalies related to utilization, costs, coding, and reimbursement.
• Develop and maintain data visualizations and dashboards specifically focused on claims data metrics to communicate key findings effectively to both technical and non-technical audiences.
• Apply statistical techniques and data mining methods to extract meaningful insights from claims data and answer critical business questions related to financial performance and operational efficiency.
• Collaborate with stakeholders to understand their data needs related to claims and translate them into analytical requirements.
• Design and implement data models and database structures optimized for claims data analysis.
• Contribute to the development and improvement of data pipelines and analytical tools for efficient claims data processing.
• Monitor and evaluate the performance of key claims-related metrics and provide regular reports on trends and variances.
• Stay up-to-date with the latest trends and regulations related to healthcare claims data and analysis.
• Document data analysis processes and findings clearly and concisely, with a specific focus on claims data insights.
• Participate in cross-functional projects, providing data-driven perspectives and recommendations based on claims data analysis.

Requirements

QUALIFICATIONS:

• Associates degree in relevant field. Bachelor's degree preferred.
• Proven experience as a Data Analyst, with a focus on analyzing healthcare claims data.
• Exceptional Excel skills.
• Excellent analytical and problem-solving skills with the ability to interpret complex claims data and translate it into actionable insights.
• Strong communication and presentation skills, with the ability to effectively convey technical information related to claims data to non-technical stakeholders.
• Ability to work independently and collaboratively in a fast-paced, startup environment.
• An understanding of healthcare claims.
• Knowledge of data privacy and security regulations (e.g., HIPAA) as they relate to claims data is critical.
• A passion for leveraging claims data to improve healthcare operations and financial performance.

WHAT WE OFFER:

• $25 per hour
• Medical Insurance
• Vision Insurance
• Life Insurance
• Short- and Long- Term Disability
• Critical Illness
• Hospital Indemnity
• Legal Assistance
• Unlimited PTO
• 401k with company match and immediate vesting