Medicare Data Specialist — SQL & BI Reporting (Onsite)

Verda Healthcare; Huntington Beach (CA); On-site; USD 29,000 - 34,000; Full time

Benefits offered by this job

401(k)

Paid time off

Health insurance

Dental Insurance

Vision insurance

Life insurance

Job summary

Verda Healthcare, Inc. is seeking a Medicare Data Coordinator to support accurate administration of Medicare programs by managing, validating, and analyzing eligibility, enrollment, and claims data.

The role collaborates with internal teams and external vendors to resolve discrepancies and identify trends that indicate errors, fraud, or waste. The position focuses on Part C and Part D data, provider data management, and related Medicare functions, requiring a strong analytical mindset and

Qualifications

• Bachelor’s degree in business, health administration, information technology, or a related field, or equivalent work experience.
• Experience with large health plan data including eligibility, enrollment, claims or provider data is preferred.
• Knowledge of data governance, data quality, and validation best practices.
• Ability to translate business questions into data requirements, queries, and reports.

Responsibilities

• Maintain, review, and validate Medicare eligibility, enrollment, and claims data for accuracy and completeness.
• Coordinate with Provider Data Management on changes from providers or vendors.
• Review contracts and program documentation to determine coverage requirements and billing implications.
• Work with Finance/Claims to troubleshoot and resolve data discrepancies.
• Prepare recurring and ad hoc reports on utilization, cost, and program performance.
• Serve as a resource for colleagues on Medicare data and processes.
• Collaborate with Leadership to align with CMS and organizational standards.
• Support cost containment by identifying unusual spending or utilization patterns.

Skills

SQL

Power BI

Tableau

Excel

Python

R

Data governance

Analytical skills

Education

Bachelor’s degree or equivalent

Tools

SQL Server

Snowflake

Oracle

ETL tools

Job description

Verda Healthcare, Inc. is seeking a Medicare Data Coordinator to support accurate administration of Medicare programs by managing, validating, and analyzing eligibility, enrollment, and claims data.

The role collaborates with internal teams and external vendors to resolve discrepancies and identify trends that indicate errors, fraud, or waste. The position focuses on Part C and Part D data, provider data management, and related Medicare functions, requiring a strong analytical mindset and