Remote Claims Analytics & Process Improvement Analyst

Centivo; Buffalo (NY); On-site; USD 80,000 - 100,000; Full time

Job summary

Centivo is seeking a Claims Business Analyst to triage operational issues and lead projects using claims adjudication experience and a TPA background. You will coordinate with vendors and internal teams during client implementations, develop advanced reporting, and drive improvements in the Claims team through data analytics.

The role requires strong SQL, Tableau, and Excel skills, with preferred familiarity in Javelina and HealthRules Payer, and a preference for Buffalo, NY.

Qualifications

• Minimum 5 years in healthcare claims and 3 years as a Business Analyst.
• Experience with automated claim adjudication systems and self-funded plans.
• Strong analytical and data-driven decision making.

Responsibilities

• Triage operational issues and lead projects to completion.
• Develop advanced reporting, dashboards, KPI’s for decision-making.
• Coordinate with vendors and internal teams during implementations.
• Analyze daily/weekly/monthly reports to identify trends and insights.
• Serve as liaison between business and technical resources for solutions.
• Participate in testing for new technology and processes.

Skills

Problem-solving

Organization

Adaptability

Relationship building

MS Office

SQL querying

Communication skills

Education

5+ years healthcare claims

3 years BA experience

Automated adjudication systems

Self-funded benefits knowledge

Tools

El Dorado-Javelina

HealthRules Payer

SQL

Tableau

JIRA

MS Excel

Job description

Centivo is seeking a Claims Business Analyst to triage operational issues and lead projects using claims adjudication experience and a TPA background. You will coordinate with vendors and internal teams during client implementations, develop advanced reporting, and drive improvements in the Claims team through data analytics.

The role requires strong SQL, Tableau, and Excel skills, with preferred familiarity in Javelina and HealthRules Payer, and a preference for Buffalo, NY.