Rialtic

We are on a mission to make healthcare more efficient.

Claims Analytics Manager

Data AnalystData AnalystFull TimeRemoteTeam 51-200H1B SponsorCompany SiteLinkedIn

Location

United States

Posted

2 days ago

Salary

Not specified

Bachelor Degree8 yrs expEnglishAWSCloudOraclePythonScalaShell ScriptingSparkSQL

Job Description

• Lead and mentor a team of Implementation Claims Analysts, setting priorities, performance expectations, and development plans. • Partner with Implementation leadership to align analytics deliverables with client goals, timelines, and success metrics. • Act as a subject-matter expert in claims analytics for complex or high-visibility client implementations. • Oversee large-scale analysis of claims data related to charge capture, reimbursement, underpayment, overpayment, and payment accuracy. • Ensure the delivery of exception-driven, actionable insights that clearly identify systemic versus isolated issues. • Review and validate analytical outputs, ensuring accuracy, consistency, and clarity in reporting and client-facing deliverables. • Guide analyses related to payor reimbursement behavior and trends, RVU productivity and payment alignment, revenue cycle optimization opportunities, and financial performance to benchmarks, goals, and norms. • Partner with GTM and Customer Success teams to support implementations, renewals, and expansion opportunities through analytics insights. • Collaborate with Product and Engineering teams to influence roadmap priorities based on claims analysis findings and client needs. • Serve as a senior analytics representative in client-facing discussions, executive readouts, and strategic reviews. • Guide data ingestion and processing pipelines using SQL*Loader, Oracle, shell scripting, and cloud-based tools. • Oversee advanced analytics leveraging SQL, PL/SQL, Python, Scala, Spark, and AWS.

Job Requirements

  • 8+ years of experience in healthcare claims analytics, payment accuracy, or reimbursement analysis.
  • Prior experience working with claims editing or payment accuracy vendors.
  • Strong expertise in medical coding, billing guidelines, and reimbursement methodologies.
  • Proven people leadership experience managing and developing analytics teams.
  • Advanced proficiency in SQL and experience working with large healthcare datasets.
  • Strong executive communication and presentation skills.

Benefits

  • Health insurance
  • Retirement plans
  • Paid time off
  • Flexible work arrangements
  • Professional development
  • Remote work options

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