Data Analyst

Key Responsibilities Data Analysis & Reporting • Analyze, validate, and compare healthcare eligibility data from multiple sources, including payer feeds, EDI 270/271, 834 files, or internal enrollment systems. • Design, write, and optimize T SQL queries, stored procedures, and scripts to extract, transform, and analyze data. • Produce recurring and ad hoc reports related to membership, eligibility status, attribution, enrollment trends, and data quality metrics. • Investigate data anomalies, discrepancies, and eligibility mismatches; provide root cause analysis and corrective recommendations. Data Management & Integrity • Maintain data accuracy and completeness across eligibility datasets. • Work with data engineers to improve data pipelines, file-processing jobs, and database performance. Cross Functional Collaboration • Partner with operations, IT, revenue cycle, and compliance to ensure eligibility data supports business processes. • Translate business questions into analytical requirements and provide clear, actionable insights. • Ensure all data handling aligns with HIPAA, PHI, and internal security policies. Documentation • Maintain documentation for eligibility data structures, data flows, and SQL processes. • Create user-friendly definitions of eligibility fields, metrics, and logic for non technical stakeholders. Required Qualifications • Bachelor’s degree in Data Analytics, Information Systems, Computer Science, Health Informatics, or a related field; or equivalent experience. • 3+ years of experience working with healthcare eligibility, enrollment, or membership data. • Strong MSSQL experience, including T SQL scripting, query optimization, joins, indexing, and stored procedures. • Familiarity with EDI formats such as 270/271, 834, 837, or payer roster files. • Proven ability to analyze large datasets and identify patterns, trends, and data quality issues. • Experience working within HIPAA regulated environments and handling PHI. • Strong communication skills, including the ability to explain technical concepts to non technical users.