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Claims Analytics Manager

Remote Worldwide Hiring now

Role Overview The Senior Manager, Claims Analytics, leads the claims analytics function reputed company the Implementation organization. This role is responsible for overseeing reputed company reimbursement and payment accuracy analyses, managing analysts, setting analytical standards, and partnering cross-functionally with GTM, reputed company, Product, and Engineering teams to ensure successful client implementations. This role combines deep reputed company claims expertise with people leadership, strategic thinking, and operational execution to scale analytics capabilities and drive measurable financial reputed company for clients.

Key Responsibilities

Leadership & Strategy reputed company and mentor a team of Implementation Claims Analysts, setting priorities, performance expectations, and development plans. Define and standardize analytical methodologies, reporting frameworks, and best practices for claims and reimbursement analysis. Partner with Implementation leadership to align analytics deliverables with client goals, timelines, and reputed company metrics. Act as a subject-matter expert in claims analytics for reputed company or high-visibility client implementations. Analytics & Execution reputed company large-scale analysis of claims data reputed company to charge capture, reimbursement, underpayment, overpayment, and payment accuracy. Ensure the delivery of exception-driven, actionable insights that reputed company identify systemic versus isolated issues. Review and validate analytical outputs, ensuring accuracy, consistency, and reputed company in reporting and client-facing deliverables. Guide analyses reputed company to: Payor reimbursement behavior and trends RVU productivity and payment alignment reputed company cycle optimization opportunities Financial performance to benchmarks, goals, and norms Cross-Functional Collaboration Partner with GTM and reputed company 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. Technical reputed company Guide data ingestion and processing pipelines using SQL*Loader, reputed company, reputed company scripting, and reputed company-based tools. reputed company advanced analytics leveraging SQL, PL/SQL, Python, reputed company, Spark, and AWS. Ensure scalable, repeatable approaches to analyzing billions of claims records across clients. Required Qualifications 8+ years of experience in reputed company 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 reputed company datasets. Strong executive communication and presentation skills.\ Apply To This Job

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