Senior Healthcare Data Analyst

The role

You will translate raw claims feeds into canonical models and drive payment integrity insights. You will use AI tooling to accelerate analysis and serve as a subject matter expert on claims flow and adjudication.

What you will do

• Design and implement data transformations for medical and institutional claims
• Perform audits to detect and resolve issues impacting accuracy and completeness
• Write SQL and Spark SQL queries to validate pipeline output
• Develop knowledge of the platform from data ingestion through claims adjudication
• Identify overpayment patterns, COB issues, and billing edit opportunities
• Drive AI adoption by prompting and iterating with LLMs
• Support onboarding of new client data feeds
• Partner with data engineers, data science, clinical staff, and product managers
• Serve as a subject matter expert on claims coding, adjudication rules, and payer policy

Required qualifications

• Bachelor's degree in Business, Computer Science, Health Informatics, or a related field
• 5+ years working directly with healthcare claims data
• Deep knowledge of claim types, coding systems, and standard form formats
• Hands-on payment integrity experience
• Familiarity with CMS regulations and commercial payer guidelines
• Advanced SQL proficiency
• Solid understanding of data modeling concepts and best practices for analytics
• Strong communicator

Nice to have

• Working knowledge of provider reimbursement methodologies
• Proficiency with Spark SQL or a comparable distributed query engine
• Exposure to ETL/ELT pipeline development
• Exposure to value-based care arrangements or risk adjustment

Benefits

• Full Medical/Dental/Vision for employees & their families
• Flexible and trusting environment
• Unlimited FTO
• Competitive salary
• Equity
• 401(k) including employer match

About the company

Machinify is a healthcare intelligence company that delivers value, transparency, and efficiency to health plan clients. It uses an AI-powered platform to maximize financial outcomes and drive down healthcare costs.