Data Analyst Pharmacy Claims

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