Pharma Claims Analytics Analyst

Forhyre; West Virginia; On-site; USD 65,000 - 90,000; Full time

Job summary

Forhyre is seeking a Claims Business Analyst to bridge IT capacity with business goals, supporting analytics, building, testing, and deployment of new features for our software product. This role collaborates with the Director of Claims to ensure timely, accurate claim payments and first-call resolution, and to optimize claim system configurations and call flows for quality and customer experience.

The analyst will develop KPIs, automate reports, and produce operational insights, working with

Qualifications

• Experience working with technology, systems and IS departments.
• Advanced Excel skills and data analysis ability.
• Pharmacy claims processing experience within managed care.
• Agile project execution experience and familiarity with scrum.

Responsibilities

• Assist in development of KPIs for claim processing and call center performance.
• Automate work distribution and maintain department metric dashboards.
• Generate and distribute weekly/monthly/quarterly reports to management.
• Summarize and distribute operational, claim data, and call center metrics.
• Ensure on-time deliverables and communicate issues to leadership.
• Identify trends in data and provide actionable recommendations.
• Collaborate with managers to refine tools for efficiency and effectiveness.
• Create data definitions, validate data, retrieve/merge data from sources.

Skills

Advanced Excel

Analytical skills

Communication skills

Pharmacy claims processing experience

Payer/PBM knowledge

Tools

Windows

Word

Business analytics tools

Job description

Forhyre is seeking a Claims Business Analyst to bridge IT capacity with business goals, supporting analytics, building, testing, and deployment of new features for our software product. This role collaborates with the Director of Claims to ensure timely, accurate claim payments and first-call resolution, and to optimize claim system configurations and call flows for quality and customer experience.

The analyst will develop KPIs, automate reports, and produce operational insights, working with