Remote Claims & Vendor Data Analyst — Overpayment Prevention

EmblemHealth; New York (NY); On-site; USD 68,040 - 118,800; Full time

Job summary

EmblemHealth in New York is seeking an experienced healthcare analyst focused on payment integrity to develop data-driven solutions for vendor operations. This role involves working with various teams to analyze payment data, prevent overpayments, and ensure compliance with healthcare regulations.

The ideal candidate should possess strong analytical skills, with at least 4-6 years in healthcare operations. Proficiency in SQL, Power BI, and a commitment to continuous improvement are essential for success.

Qualifications

• 4–6+ years’ experience in healthcare and managed care operations.
• Extensive knowledge of healthcare provider audit methods.
• Proven ability to apply quantitative research to improve processes.

Responsibilities

• Develop and analyze vendor payment data to improve recovery and prevent overpayments.
• Collaborate with teams to implement financial recovery strategies.
• Create and present dashboards and reports to stakeholders.

Skills

Data analysis

Process improvement

Vendor management

Claims analysis

Stakeholder collaboration

Education

Bachelor’s degree

Tools

SQL

Power BI

Tableau

Excel

Job description

EmblemHealth in New York is seeking an experienced healthcare analyst focused on payment integrity to develop data-driven solutions for vendor operations. This role involves working with various teams to analyze payment data, prevent overpayments, and ensure compliance with healthcare regulations.

The ideal candidate should possess strong analytical skills, with at least 4-6 years in healthcare operations. Proficiency in SQL, Power BI, and a commitment to continuous improvement are essential for success.