Healthcare Data Analyst

About FAIR Health

FAIR Health, Inc., a national, independent nonprofit organization, was established in October 2009 with the mission to help assure fairness and transparency in health insurance information. FAIR Health has created a database of over 45 billion de-identified private healthcare claim records—the largest in the country—which receives claims monthly and which serves as the foundation for a variety of data products, custom analytics and consumer tools. FAIR Health has also been certified by the Centers for Medicare & Medicaid Services as a “Qualified Entity” and thus holds the entire collection of Medicare Parts A, B and D claims from 2013 to the present, which get routinely refreshed.

Our standard data modules, custom analytics and technological tools serve all participants in the healthcare sector nationwide; they are licensed to payors, third-party administrators, bill review companies, self-insured employers, government agencies, academic researchers and consultants. Our medical and dental data are used to inform statutes and regulations, healthcare cost indices, fee schedules, benefit and provider network design, practice/facility expansion, health systems research and dispute resolution, among other uses. We also offer a suite of consumer-oriented tools and resources available on our consumer website (fairhealthconsumer.org), as well as a mobile application, which can be licensed by other organizations.

Summary of Position

This multifaceted position is responsible for healthcare claims data analysis and data validation. The individual in this role will assist in the acquisition, validation, management and translation of healthcare claims data, and will be responsible for daily evaluation of ongoing data feeds, interpretation and investigation of nuances within the data, as well as maintaining a high-quality healthcare claims dataset for use in FAIR Health products and offerings.

The Healthcare Data Analyst will work with healthcare claims data and write SQL queries to organize the data and sort, summarize and report salient changes within the datasets.

This position requires an individual with analytic skills and an understanding of healthcare claims data. This person will be detail-oriented and able to analyze changes and present differences. The ideal candidate enjoys working in a fast-paced and challenging environment. The Healthcare Data Analyst supports the business and interacts with external customers.

Primary Responsibilities

· Aid internal staff in the validation and analysis of incoming healthcare claims datasets daily.

· Evaluate healthcare claims data, interpret and investigate datasets for any changes that may impact downstream processes.

· Collaborate with internal staff to work with external data contributors on their ongoing data feeds.

· Evaluate and validate the accuracy of healthcare claims datasets to correct healthcare information, including, but not limited to, CPT®, HCPCS and ICD-10 procedure codes, as well as ICD-10 diagnosis codes.

· Evaluate and establish the validity of incoming claims data and data element combinations to ensure accuracy and completeness of all reporting results.

· Support data translation initiatives.

· Use SQL, MS Office tools to organize and aggregate data and summarize for reporting.

· Collaborate with data and product staff on various aspects of incoming healthcare claims data.

· Facilitate completion of contributor Useable Data Forms when required.

· Complete required status reports of weekly activities.

· Communicate with clients regarding incoming data validation.

· Observe information security policies and HIPAA guidelines of conduct to ensure the privacy and security of nonpublic information.

Knowledge and Skill Requirements

· Bachelor’s Degree in Mathematics, Statistics, Healthcare Administration or IT advantageous.

· Extremely detail-oriented with strong analytic skills.

· Possess an understanding of and prior experience working with healthcare claims data, including, but not limited to, inpatient claims, outpatient claims, professional claims and specialty pharmacy and pharmaceutical claims.

· Knowledge of claims billing forms data elements: UB-04 (institutional), CMS-1500 (professional), dental and/or state-specified forms, including paper and electronic versions.

· Knowledge and understanding of healthcare claim code sets (e.g., DRG, ICD, CPT, HCPCS and revenue codes).

· Strong SQL skills required; Oracle experience is a plus.

· Strong written and verbal communication skills.

· Ability to translate and organize disparate datasets to a standard format.

· Resourceful in identifying and finding patterns and trends in data analysis and providing recommendations for improvement.

· Effective communication and interpersonal skills, including the ability to work in a remote, cross-functional, multilocation organization.

· Enthusiasm for working at the intersection of healthcare and technology with analytic, business development, IT, sales and other associates.

· Comprehensive knowledge of MS Office suite of products, including Excel and PowerPoint.

· Demonstrated desire to understand healthcare operations and systems and their potential downstream impacts on the data.

Our office is based in New York City, but we are currently remote and open to candidates looking for remote work.

Salary Range: $70,000 - $80,000

FAIR Health, Inc., is an equal opportunity employer and is an E-Verify participant.

All qualified applicants will receive consideration for employment without regard to race, height, weight, color, religion, sex, sexual orientation, gender identity or national origin.

FAIR Health offers a competitive compensation package and includes the following benefits: Medical, Dental, Vision, Flexible Spending and Dependent Care Accounts, Life and Disability Insurance, Paid Time Off, Paid Holidays, 401(k) and Discretionary Bonus.

Job Type: Full-time

Pay: $70,000.00 - $80,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Parental leave
• Retirement plan
• Vision insurance
• Work from home

Work setting:

• Remote

Application Question(s):

• Are you at least 18 years or older?
• Do you require sponsorship now or in the future?
• How much notice does your current employer require?
• What are your salary requirements?
• Are you authorized to work in the United States?

Work Location: Remote