Forensic Data Analyst, Specialist

Remote Full-time
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Forensic Data Analyst, Specialist plays a pivotal role in advancing our products and services by shaping solution design and supporting strategic decision-making. Collaborates closely with engineers, clinical experts, payment professionals, and business operations leaders to develop reporting and analyze large-scale healthcare claims and clinical datasets. Generates new analytic content aimed at ensuring claims are paid accurately. Leverages advanced coding, analytic reporting, and predictive modeling to uncover actionable insights that drive innovation and improve outcomes across the organization. ESSENTIAL JOB RESPONSIBILITIES & KEY PERFORMANCE OUTCOMES: Work cross functionally to identify opportunities for leveraging company data to drive business solutions. Mine and analyze data from healthcare claim databases to drive optimization and improvement of product development, sales, marketing techniques, and business strategies. Design and develop business intelligence reporting suite for internal and external consumption. Author new analytic content aimed at ensuring health plans pay accurate and reasonable amounts for claims submitted on behalf of their members. Partner with Data Science and Engineering to develop custom complex SQL queries and algorithms to apply to data sets. Partner with Data Science and Engineering to create predictive modeling to support business reporting and decision making. Coordinate with different functional teams to implement models and monitor outcomes. Develop processes to monitor and analyze model performance and accuracy of results. Qualifications Minimum of 10 years experience manipulating data sets and building statistical models through SQL, and more advanced technologies. Minimum of 7 years experience with healthcare data and standard UB/HCFA claim fields. Experience using and developing in enterprise level business intelligence tools (e.g. PowerBI, Sigma, Tableau, Domo). Requirements Bachelor's degree in business or healthcare/related field (preferred). Excellent written and verbal communication skills for coordinating across teams and with customers. Experience partnering with Data Science teams to ideate algorithms and models, using statistical computer languages (SQL, Python, R) to manipulate data and generate insights from large data sets. Experience working in project management tools (Jira, Confluence) employing proficiency in time management abilities. Strong problem-solving skills with an emphasis on product development. Drive to learn and master new technologies and techniques. Experience building, and delivering, compelling presentations in PowerPoint (or similar). Experience across multiple Payment Integrity product areas (e.g. Edits, Data Mining, Coordination of Benefits, SIU, etc). Benefits The US base salary range for this full-time position is: $146,910.00 - $220,366.00. The specific salary offered to a candidate may be influenced by a variety of factors including but not limited to the candidate’s relevant experience, education, and work location. Please note that the compensation details listed in US role postings reflect the base salary only, and does not reflect the value of the total rewards compensation. Company Description Lyric is an AI-first, platform-based healthcare technology company, committed to simplifying the business of care by preventing inaccurate payments and reducing overall waste in the healthcare ecosystem. Enabling more efficient use of resources to reduce the cost of care for payers, providers, and patients. Formerly ClaimsXten, is a market leader with 35 years of pre-pay editing expertise. Recognized as 2025 Best in KLAS for Pre-Payment Accuracy and Integrity. HI-TRUST and SOC2 certified. Apply tot his job
Apply Now

Similar Opportunities

Investigator (Forensic Accounting)

Remote Full-time

FP&A Analyst-Ambient

Remote Full-time

Fraud Investigator - UT, AZ, NV (Remote)

Remote Full-time

Financial Planning and Analyst

Remote Full-time

Manager, Digital Forensics and eDiscovery Remote Worker – Illinois, USA

Remote Full-time

Fraud Investigator, Money

Remote Full-time

Consulting Associate/Computer Scientist (Forensic Services practice) (Washington)

Remote Full-time

Healthcare Investigator-Fraud Lead Analyst-Remote

Remote Full-time

Standout Business Intelligence Consultant (Tableau, Power BI, Looker) - Flexible, Easygoing Vibes

Remote Full-time

Business Consultant Needed to Help Launch Hospitality Consulting Company

Remote Full-time

**Experienced Customer Service Agent – English Speaker (Part-Time / Night Shift) at blithequark**

Remote Full-time

**Experienced Data Entry Clerk – Remote Opportunity for a Highly Organized and Detail-Oriented Individual at blithequark**

Remote Full-time

**Experienced Full Stack Customer Service Representative – Remote Customer Support**

Remote Full-time

Experienced WFH Online Chat Representative and Live Chat Agent for Military Support – Providing Exceptional Customer Service and Guidance to Military Personnel and Their Families

Remote Full-time

Experienced Remote Data Entry Clerk for Culture and Democracy Organization - Work from Home Opportunity

Remote Full-time

(Remote) Technical Writer, Research & Development in Vermont

Remote Full-time

Experienced Customer Service Representative – Remote Work Opportunity with blithequark

Remote Full-time

Senior Project Manager Finance Fuze Health

Remote Full-time

Senior Pharmacy Technician - Remote Opportunity in Vermont: Join Our Team and Make a Difference in Healthcare

Remote Full-time

Experienced Customer Service Representative – Remote Work Opportunity with arenaflex, Focusing on Exceptional Client Experience and Personal Growth

Remote Full-time
← Back to Home