Remote Senior Data Analyst - Claims Reconciliation Hub

Vytwo; United States; Remote; USD 100,000 - 140,000; Full time

Job summary

Vytwo is seeking a Senior Data Analyst to support the development of a Claims Reconciliation Hub. The role focuses on defining and analyzing matching criteria between pre-service estimates and actual medical claims across multiple lines of business.

The ideal candidate has extensive healthcare claims data experience, strong Snowflake and data warehousing capabilities, and a working knowledge of health plan claims processing.

Qualifications

• 5+ years of experience as a Data Analyst in data warehousing and healthcare data.
• 3+ years analyzing healthcare claims data in enterprise data warehouse environments (e.g., UDW).
• Experience with healthcare claims platforms (CSP Facets, UNET, COSMOS, USP).
• Strong understanding of medical claims processing, adjudication and payment workflows.
• Proficient in Snowflake data exploration and querying healthcare data.

Responsibilities

• Define matching criteria between pre-service estimates and final adjudicated claims.
• Analyze claims data to identify patterns, relationships, and reconciliation opportunities.
• Trace claims from initial receipt through final adjudication, payment, and reporting.
• Identify data sources, attributes, identifiers, and source-system relationships for reconciliation.
• Explain and document how member, provider, benefit, pricing, and data elements should be interpreted.
• Analyze claim changes during processing lifecycle, including edits, prior auth matching, and pricing.
• Develop insights to improve matching of estimates and claims.
• Perform data exploration using Snowflake and data warehouse assets.
• Document data logic, mappings, and data gaps.
• Communicate findings clearly to technical and nontechnical stakeholders.
• Support reconciliation design across multiple lines of business and platforms.

Skills

Snowflake

Data analysis

Healthcare data

Data warehousing

Stakeholder management

Communication

Independent worker

Tools

CSP Facets

UNET

COSMOS

USP

Job description

Vytwo is seeking a Senior Data Analyst to support the development of a Claims Reconciliation Hub. The role focuses on defining and analyzing matching criteria between pre-service estimates and actual medical claims across multiple lines of business.

The ideal candidate has extensive healthcare claims data experience, strong Snowflake and data warehousing capabilities, and a working knowledge of health plan claims processing.