{"schemaVersion":"jobsearcher.job.v1","id":"a51778342cec6d9c0d37b7dd","url":"https://jobsearcher.com/jobs/a51778342cec6d9c0d37b7dd","canonicalUrl":"https://jobsearcher.com/jobs/a51778342cec6d9c0d37b7dd","title":"Healthcare Data Analyst - Algorithm Developer","description":"Job Description: Analyze healthcare claims, encounter, provider, and medical record-related data to identify trends, anomalies, outliers, and potential coding or billing compliance risks.\r\nDevelop, test, validate, and maintain algorithms, business rules, and SQL queries used to support coding reviews, audit targeting, payment integrity, and compliance monitoring activities.\r\nTranslate coding, reimbursement, and policy requirements into data logic that can be used to flag records, claims, or providers for further review.\r\nSupport development of analytical models and rule sets related to CPT, HCPCS, ICD-10, modifiers, place of service, units, and other claims elements.\r\nReview data outputs for accuracy, reasonableness, and alignment with review objectives, audit scopes, and program policies.\r\nPartner with coders, auditors, clinicians, and compliance staff to understand review requirements and convert those requirements into repeatable analytic approaches.\r\nIdentify patterns related to documentation deficiencies, claim errors, utilization anomalies, denial trends, overpayment risks, and potential fraud, waste, and abuse indicators.\r\nPrepare data files, summaries, scorecards, dashboards, and reports for internal stakeholders, audit teams, and program leadership.\r\nSupport record selection methodologies for audits, sampling, monitoring, and focused reviews using claims and related data.\r\nPerform data validation, quality checks, reconciliation activities, and root cause analysis to ensure reliability of analytic outputs.\r\nDocument query logic, technical methods, assumptions, and validation steps in a clear and reproducible manner.\r\nAssist with ad hoc analysis related to coding accuracy, reimbursement trends, provider billing patterns, and policy changes.\r\nSupport maintenance of reference tables, edit logic, provider attributes, coding crosswalks, and other data assets used in analytics.\r\nMonitor impacts of coding and regulatory updates on data logic, algorithms, and analytic reporting.\r\nCollaborate with internal stakeholders to improve audit efficiency, targeting precision, and reporting clarity.\r\nAdapt quickly to changing priorities, evolving business rules, and new review requirements while meeting deadlines and maintaining quality.\r\nRequirements: Bachelor's degree in data analytics, health information management, informatics, public health, healthcare administration, statistics, computer science, or a related field preferred.\r\nAt least 2 years of experience in healthcare data analysis, claims analysis, payment integrity, program integrity, revenue cycle analytics, or related work preferred.\r\nStrong experience with SQL required, including writing complex queries, joining large datasets, aggregating results, and validating outputs.\r\nWorking knowledge of medical coding concepts, including CPT, HCPCS, and ICD-10, strongly preferred.\r\nExperience working with healthcare claims or encounter data required; Medicaid experience strongly preferred.\r\nFamiliarity with healthcare billing, reimbursement, documentation review, audit support, or compliance monitoring preferred.\r\nExperience developing logic models, analytic rules, dashboards, or automated reporting solutions preferred.\r\nProficiency in Microsoft Excel required; experience with data visualization and reporting tools preferred.\r\nStrong analytical, critical thinking, problem-solving, and organizational skills.\r\nAbility to communicate technical findings clearly to non-technical audiences.\r\nStrong attention to detail and ability to manage multiple datasets, priorities, and deadlines.\r\nAbility to work independently and collaboratively in a fast-paced environment.\r\nBenefits: Health insurance\r\n401(k) matching\r\nFlexible working hours\r\nPaid time off\r\nRemote work options","company":"Remote Rocketship","rawCompany":"remoterocketship","city":"Remote","state":"OR","isRemote":false,"isActive":false,"createdAt":"2026-05-14T03:49:26.513Z","occupations":[{"code":"15-1243.01","title":"Data Warehousing Specialists","slug":"data-warehousing-specialists"},{"code":"15-2051.02","title":"Clinical Data Managers","slug":"clinical-data-managers"},{"code":"29-9021.00","title":"Health Information Technologists and Medical Registrars","slug":"health-information-technologists-and-medical-registrars"}],"industries":[{"code":"622110","title":"General Medical and Surgical Hospitals","slug":"general-medical-and-surgical-hospitals"},{"code":"524292","title":"Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds","slug":"pharmacy-benefit-management-and-other-third-party-administration-of-insurance-and-pension-funds"},{"code":"621999","title":"All Other Miscellaneous Ambulatory Health Care Services","slug":"all-other-miscellaneous-ambulatory-health-care-services"}],"jobPosting":{"@context":"https://schema.org","@type":"JobPosting","title":"Healthcare Data Analyst - Algorithm Developer","description":"Job Description: Analyze healthcare claims, encounter, provider, and medical record-related data to identify trends, anomalies, outliers, and potential coding or billing compliance risks.\r\nDevelop, test, validate, and maintain algorithms, business rules, and SQL queries used to support coding reviews, audit targeting, payment integrity, and compliance monitoring activities.\r\nTranslate coding, reimbursement, and policy requirements into data logic that can be used to flag records, claims, or providers for further review.\r\nSupport development of analytical models and rule sets related to CPT, HCPCS, ICD-10, modifiers, place of service, units, and other claims elements.\r\nReview data outputs for accuracy, reasonableness, and alignment with review objectives, audit scopes, and program policies.\r\nPartner with coders, auditors, clinicians, and compliance staff to understand review requirements and convert those requirements into repeatable analytic approaches.\r\nIdentify patterns related to documentation deficiencies, claim errors, utilization anomalies, denial trends, overpayment risks, and potential fraud, waste, and abuse indicators.\r\nPrepare data files, summaries, scorecards, dashboards, and reports for internal stakeholders, audit teams, and program leadership.\r\nSupport record selection methodologies for audits, sampling, monitoring, and focused reviews using claims and related data.\r\nPerform data validation, quality checks, reconciliation activities, and root cause analysis to ensure reliability of analytic outputs.\r\nDocument query logic, technical methods, assumptions, and validation steps in a clear and reproducible manner.\r\nAssist with ad hoc analysis related to coding accuracy, reimbursement trends, provider billing patterns, and policy changes.\r\nSupport maintenance of reference tables, edit logic, provider attributes, coding crosswalks, and other data assets used in analytics.\r\nMonitor impacts of coding and regulatory updates on data logic, algorithms, and analytic reporting.\r\nCollaborate with internal stakeholders to improve audit efficiency, targeting precision, and reporting clarity.\r\nAdapt quickly to changing priorities, evolving business rules, and new review requirements while meeting deadlines and maintaining quality.\r\nRequirements: Bachelor's degree in data analytics, health information management, informatics, public health, healthcare administration, statistics, computer science, or a related field preferred.\r\nAt least 2 years of experience in healthcare data analysis, claims analysis, payment integrity, program integrity, revenue cycle analytics, or related work preferred.\r\nStrong experience with SQL required, including writing complex queries, joining large datasets, aggregating results, and validating outputs.\r\nWorking knowledge of medical coding concepts, including CPT, HCPCS, and ICD-10, strongly preferred.\r\nExperience working with healthcare claims or encounter data required; Medicaid experience strongly preferred.\r\nFamiliarity with healthcare billing, reimbursement, documentation review, audit support, or compliance monitoring preferred.\r\nExperience developing logic models, analytic rules, dashboards, or automated reporting solutions preferred.\r\nProficiency in Microsoft Excel required; experience with data visualization and reporting tools preferred.\r\nStrong analytical, critical thinking, problem-solving, and organizational skills.\r\nAbility to communicate technical findings clearly to non-technical audiences.\r\nStrong attention to detail and ability to manage multiple datasets, priorities, and deadlines.\r\nAbility to work independently and collaboratively in a fast-paced environment.\r\nBenefits: Health insurance\r\n401(k) matching\r\nFlexible working hours\r\nPaid time off\r\nRemote work options","datePosted":"2026-05-14T03:49:26.513Z","dateModified":"2026-05-14T03:49:26.513Z","hiringOrganization":{"@type":"Organization","name":"Remote Rocketship","sameAs":"https://jobsearcher.com"},"jobLocation":{"@type":"Place","address":{"@type":"PostalAddress","addressLocality":"Remote","addressRegion":"OR","addressCountry":"US"}},"identifier":{"@type":"PropertyValue","name":"JobSearcher","value":"a51778342cec6d9c0d37b7dd"},"url":"https://jobsearcher.com/jobs/a51778342cec6d9c0d37b7dd"}}