Senior Healthcare Data Analyst

Machinify
United States
Workplace: RemoteFull timeUSD 140,000 - 170,000 annuallyFunction: Data Analytics & Business IntelligenceEducation: bachelorsSkills: ["Communication","Ownership","Accountability","Stakeholder management","Problem-solving"]

Build trusted canonical models from raw healthcare claims to power payment integrity insights at scale. You’ll design claims transformations (837 EDI, UB-04, CMS-1500), validate data quality with SQL/Spark SQL, and identify overpayment patterns using payer policy and CMS regulations. Partner with data engineering, data science, clinical teams, and product to translate complex claims/adjudication requirements, while driving AI-assisted workflows with LLMs to accelerate analysis and automation.

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FursaFursa
Machinify
Machinify
1 day ago

Senior Healthcare Data Analyst

✓ Verified Job

Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI
Last checked: 2 hours agoStatus: Live

Job Summary

Build trusted canonical models from raw healthcare claims to power payment integrity insights at scale. You’ll design claims transformations (837 EDI, UB-04, CMS-1500), validate data quality with SQL/Spark SQL, and identify overpayment patterns using payer policy and CMS regulations. Partner with data engineering, data science, clinical teams, and product to translate complex claims/adjudication requirements, while driving AI-assisted workflows with LLMs to accelerate analysis and automation.
Location: United States
Workplace: Remote
Employment Type: Full time
Job Function: Data Analytics & Business Intelligence
Seniority: Mid level

Key Responsibilities

  • •Design and implement data transformations that convert raw medical and institutional claims (837 EDI, UB-04, CMS-1500) into canonical models using healthcare coding standards.
  • •Perform data quality audits and pipeline validation by detecting and resolving issues, and by writing SQL and Spark SQL queries to verify outputs end-to-end.
  • •Develop platform expertise across data ingestion through claims adjudication so analytical solutions are accurate, traceable, and business-aligned.
  • •Identify payment integrity opportunities such as overpayment patterns, COB issues, and billing edit opportunities using payer policy and CMS regulations.
  • •Drive AI-assisted workflows by prompting and iterating with LLMs to accelerate analysis and contribute to AI-assisted pipeline development.

Pay and Benefits

Salary: USD 140,000 - 170,000 annually
Equity and Bonus:Equity
Perks:Health InsuranceDentalVision401kEquityPaid Leave

Key Requirements

  • •Bachelor’s degree in Business, Computer Science, Health Informatics, or a related field.
  • •5+ years working directly with healthcare claims data (837 EDI, encounter data, medical billing).
  • •Deep knowledge of claim types (professional and institutional), coding systems (ICD-10-CM/PCS, CPT, HCPCS), and standard forms (UB-04, CMS-1500).
  • •Hands-on payment integrity experience including overpayment detection, COB, billing edits, or claim editing logic.
  • •Advanced SQL proficiency and comfort writing complex analytical queries on large datasets.
Experience:HealthcareHealthcare analyticsHealth plansPayment integrityMedical billingClaims data
Education:Bachelor's
Skills:CommunicationOwnershipAccountabilityStakeholder managementProblem-solving
Languages:English
Tech Stack:SQLSpark SQLLLMsAIEDI837 EDIUB-04CMS-1500ICD-10-CMICD-10-PCSCPTHCPCSData modelingETL/ELT

Company Brief

Machinify
Provides AI-driven predictive maintenance and asset-monitoring solutions for manufacturing and industrial operations, using IoT sensor data and machine learning to reduce downtime, optimize performance, and extend equipment life.
Industry: Industrial Automation
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