Lead - Claims

About the role

As a Lead , you will work with US healthcare payer clients to identify opportunities that reduce medical and administrative costs, improve payment accuracy, and strengthen operational performance. You will help clients understand business issues, dig into the data, and develop recommendations that can be put into action.

What you'll do

• Research payer topics, industry trends, regulations, operating models, and client-specific business issues
• Review and analyze medical, eligibility, provider, pricing, reimbursement, and other healthcare data to find trends, issues, and opportunities
• Use SQL and other tools to work through large datasets and evaluate utilization, cost drivers, reimbursement patterns, payment accuracy, and operational performance
• Check data quality, test assumptions, document the logic behind the analysis, and make sure the work can stand up to client review
• Develop recommendations, business cases, and implementation plans tied to cost savings, process improvement, medical cost management, and operational efficiency

What you need

• Excel
• SQL
• Data structures
• Snowflake

Good to have

• Claims processing