Claims Data & Strategy Analyst

We are seeking a highly skilled and strategically minded Claims Data & Strategy Analyst to join our Benefit Infrastructure & Strategy team. In this role, you will be responsible for identifying, analyzing, and clearly communicating claims processing and payment errors within our VBA claim processing system and proprietary database. Your insights will directly support strategic initiatives aimed at improving accuracy, reducing operational costs, and strengthening cross-team collaboration to drive measurable impact.

The ideal candidate thrives at the intersection of data analytics, healthcare operations, and process improvement, with the ability to transform raw claims and operational data into actionable insights that drive measurable results.

Responsibilities

• Claims Data Analysis
  
  • Extract, clean, and analyze claims data from the VBA claim system to identify error trends, root causes, and recurring issues.
  • Develop and maintain dashboards/reports, highlighting claims performance, error frequency, and financial impact.
  • Develop and deliver ad hoc reports as required or upon stakeholder request.
• Operational Insights & Prioritization
  
  • Partner with the Operations team to review Jira tickets, organize issues by frequency, cost, and operational impact, analyze trends, and help prioritize fixes in collaboration with Engineering.
  • Partner with leadership to identify potential projects, define requirements, and develop cost-benefit analyses to inform prioritization and ensure focus on initiatives with the highest return on investment.

• Stakeholder Communication
  
  • Translate technical and operational findings into clear summaries for leadership, stakeholders, and cross-functional teams.
  • Present error trends, resolution status, and performance metrics in a way that drives clarity and action.
• Process Improvement & Collaboration
  
  • Partner with Operations, Engineering, and other teams to ensure issue resolution breaks down silos and accelerates fixes.
  • Identify opportunities to streamline benefit code accuracy, claim adjudication logic, and error prevention.

Qualifications

Required:

• 3+ years of experience in data analysis, healthcare operations, or claims analytics.
• Advanced SQL and API skills to extract and analyze claims data from VBA or similar platforms.
• Extensive experience leveraging Jira for advanced issue tracking, prioritization, and cross-functional collaboration, with the ability to organize complex workflows and drive resolution of high-impact initiatives.
• Proven ability to conduct cost-benefit analyses and translate findings into actionable recommendations.
• Excellent organizational and communication skills with the ability to explain technical findings to non-technical stakeholders.

Preferred:

• Experience with VBA claims processing or other healthcare claims adjudication systems.
• Familiarity with benefit structure, adjudication logic, and industry coding standards (CPT, ICD, taxonomy, specialties, etc.).
• Prior experience working in an operations + engineering cross-functional environment.
• Experience with dashboarding tools (Tableau, Power BI, Looker) for visualizing operational and claims data.