Data Analyst (Healthcare Claims & Remittance) - Remote

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The Data Analyst owns the end-to-end preparation, validation, and quality assurance of institutional and professional healthcare claims and remittance data for providers and payers used in analytics and client deliverables.

Responsibilities:

• Coordinate secure data transfers with client data contacts
• Own client data intake, processing, and readiness for downstream analytics
• Proactively identify risks, gaps or anomalies and recommend solutions
• Design, write, and optimize SQL queries to validate data accuracy, completeness, and consistency
• Reconcile sophisticated discrepancies between client submissions, control totals and expected benchmarks
• Perform advanced volume, utilization, and trend-based reasonableness checks
• Establish repeatable validation patterns and contribute to data quality standards
• Independently reformat, map and normalize complex datasets to internal schemas across many products in support of multiple external stakeholders
• Apply deep understanding of data elements (e.g., ICD, CPT/HCPCS, DRGs, revenue codes, payer adjudication system processing)
• Support analytic use cases through accurate case and category mapping
• Serve as a primary point of contact for clients/data contacts on data-related issues
• Clearly explain technical data problems and solutions to non-technical stakeholders
• Partner with analytics and system teams to align data preparation with analytic needs
• Maintain and enhance data reference tables and documentation
• Identify opportunities to improve data intake, validation, and QA processes
• Provide guidance and informal mentorship to junior analysts

Requirements:

• 3+ years of experience in data analysis of healthcare claims data
• 2+ years of experience in SQL with the ability to perform complex table joins, aggregations, and validation logic
• Direct experience with healthcare claims, remittance, or payer data
• Demonstrated familiarity with industry-standard code sets (ICD-10, CPT/HCPCS, DRGs)
• Proven ability to independently manage data workflows and resolve issues end-to-end
• Proven solid analytical reasoning and problem-solving skills
• Demonstrated ownership mindset and comfort working with minimal supervision
• Experience supporting multiple clients or projects concurrently