Claims Management Data Jobs

1 job found

7d ago

Data Analyst Pharmacy Claims

eNGINE Pittsburgh, PA

Pittsburgh, PA

7d ago

$105k - $125k/yr Full time Analyst APIs Claims Analysis

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Job Description

Data Analyst role focused on pharmacy claims processing at eNGINE in Pittsburgh, PA (hybrid); salary USD 105,000 - 125,000 per year; minimum 4 years of relevant experience.

Responsibilities

Act as the technical primary liaison for pharmacy claims processing and customer implementations.
Own and manage customer data pipelines from initial deployment through ongoing production operations.
Investigate claim failures and rejection causes, identify root causes, and coordinate timely fixes.
Use SQL to analyze pharmacy claims data, troubleshoot production issues, and validate customer data.
Collaborate with insurers, PBMs, pharmacies, and internal teams to address complex claims questions.
Translate business needs into well-structured technical documentation for developers.
Collaborate with engineering to enhance system functionality, data quality, and operational efficiency.
Support deployments, testing, and production releases while ensuring data accuracy.
Identify recurring claim issues and propose process improvements to minimize defects affecting customers.

Requirements

4+ years of experience as a Technical Business Analyst, Business Analyst, or similar technical support role.
Solid understanding of pharmacy claims processing, including lifecycle, adjudication, and typical rejection reasons.
Experience researching and explaining pharmacy claims rejection codes and guiding claim resolution.
Proficient SQL skills to query relational databases for data investigation and production issue analysis.
Experience supporting external customers such as insurers, PBMs, pharmacies, or other healthcare organizations.
Strong analytical and troubleshooting capabilities.
Excellent communication skills for effective collaboration across technical and business teams.

Technologies

SQL
Python
PowerShell
APIs

Benefits

Dental insurance
Health insurance
Life insurance
Vision insurance

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