Senior Claims Systems Analyst, AI-Driven Health Tech

Jobgether; Oregon; Hybrid; USD 110,000 - 165,000; Full time

Benefits offered by this job

Medical coverage

Vision & dental

401(k) plan

Paid time off

Telehealth access

Parental leave

Job summary

Jobgether seeks a Sr Claims Systems Analyst — AI-Enabled in the United States to blend healthcare payer expertise with hands-on AI-driven development. You will analyze complex adjudication, pricing, benefits, configuration, and payments, using SQL and AI tools to diagnose defects and prepare engineering-ready fixes.

You will collaborate with Claims Operations and Engineering to reduce errors, strengthen automated controls, and improve processing accuracy, efficiency, and cost savings in a

Qualifications

• 5+ years of hands-on healthcare payer experience in claims adjudication, pricing or benefits.
• Experience configuring or troubleshooting production claims platforms.
• Strong SQL skills to trace data, configuration and logic issues.
• Practical use of AI-assisted coding tools to create or modify code.
• Familiarity with Git, PR workflows and software testing.
• Exposure to data analytics tools such as Snowflake or similar platforms.

Responsibilities

• Investigate complex claims adjudication, pricing, benefits, configuration and payment issues to pinpoint root causes and craft solutions.
• Trace processing issues with SQL and system data; quantify financial exposure and validate findings.
• Apply AI-assisted coding tools to investigate code, develop fixes, write tests, and prepare PRs.
• Reproduce defects, test corrections, and verify accurate claims outcomes.
• Collaborate with Claims Operations and Engineering to resolve production issues and reduce defects.
• Support automated controls, advanced claims editing and AI-enabled workflow enhancements.
• Develop and improve audit tools, operational policies, procedures, and monitoring processes.
• Validate configurations and reimbursement logic to ensure consistent processing.
• Translate technical findings into actionable recommendations for stakeholders and engineers.
• Contribute to platform improvements through automation and structured testing.

Skills

Healthcare payer experience

SQL skills

Git workflows

Python scripting

Analytical thinking

Education

Bachelor's degree in related field

Tools

Claude Code

OpenAI Codex

Snowflake

Streamlit

Google Workspace

Git

Job description

Jobgether seeks a Sr Claims Systems Analyst — AI-Enabled in the United States to blend healthcare payer expertise with hands-on AI-driven development. You will analyze complex adjudication, pricing, benefits, configuration, and payments, using SQL and AI tools to diagnose defects and prepare engineering-ready fixes.

You will collaborate with Claims Operations and Engineering to reduce errors, strengthen automated controls, and improve processing accuracy, efficiency, and cost savings in a