Clinical Data Analyst
The Clinical Data Analyst is a multi-faceted position with responsibilities ranging from data analysis to clinical content development, supporting the business as well as external customers. The incumbent will work with other data analysts, managers and clinical staff to provide opinions on and assist in the explanation of complex issues related to healthcare claims and how they are coded. The Clinical Data Analyst will participate in product review and root-cause analyses related to data quality issues and will assist with developing data analysis protocols to help the team make product decisions.
The Clinical Data Analyst will work with healthcare claims data and be responsible for writing SQL queries. These queries will be written to manage the data and to sort, summarize and report on various healthcare trends and information to help meet the organization’s goal. The incumbent also will support other staff in managing the clinical data aspects of the organization, assisting with procuring, maintaining and integrating the clinical content into FAIR Health’s products.
The successful candidate will possess a thorough knowledge of healthcare claims data as well as analytic skills, and must thrive in a fast-paced and challenging environment.
- Aid internal staff in understanding complex issues regarding the coding of healthcare claims;
- Evaluate, analyze and implement CPT®, CDT®, HCPCS and DRG code additions/changes/deletions for integration into FAIR Health products and offerings;
- Evaluate and establish the validity of claims data and data element combinations to ensure the accuracy and completeness of all reporting results;
- Use SQL to conduct data management, summarization and reporting;
- Collaborate with data and product staff on methods, analysis and production of reports; and
- Assist customer support team in responding to client inquiries.
Knowledge and Skill Requirements
- A deep understanding of and prior experience in working with medical claims data, including, but not limited to, inpatient, outpatient, professional, specialty pharmacy and pharmaceutical claims;
- Comprehensive knowledge of all appropriate billing forms, among them UB-04, CMS-1500 and state- specified forms, including paper and electronic versions; working knowledge of Oracle based SQL;
- Working knowledge of relational databases or, at minimum, the willingness to learn;
- Familiarity with healthcare billing, coding and payment guidelines/practices/regulations both in the commercial and government space;
- Working knowledge of Oracle-based SQL;
- Coding experience preferred but not required. Otherwise, the candidate must have a deep familiarity with all healthcare claim code sets (e.g., DRG, ICD, CPT, CDT, HCPCS and revenue codes);
- Comprehensive knowledge of MS Office suite of products, including, but not limited to Excel and PowerPoint;
- Excellent written and verbal communication skills;
- Detail-oriented with strong analytic skills; and
- Strong interpersonal skills, including the ability to work in a highly cross-functional, multi-location organization.
A four-year degree in a related discipline (e.g., computer science, software engineering, information systems) or relevant experience required.
Interested candidates should submit their resume to firstname.lastname@example.org. Please include “Clinical Data Analyst” and your last name in the subject line.
FAIR Health, Inc. is an equal opportunity employer and an e-verify participant.