HealthCare Claims Analyst

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This role is a Full‑Time Health Care Claims Analyst based in New York, NY, offering a competitive salary of $58,039.46 to $65,294.40. Requires 5 years of healthcare claims experience, advanced SQL and Excel skills, and knowledge of Medicaid/Medicare guidelines.

Location:

New York, NY

Schedule:

Hybrid

Join Village Care as a Full‑Time Health Care Claims Analyst and take your career to the next level while working from the comfort of your home. This position offers great financial incentives and a flexible work‑life balance through a hybrid schedule.

• Analyze healthcare reimbursement from both financial and operational perspectives.
• Conduct audits and perform root‑cause analysis to resolve identified issues with internal teams and TPAs.
• Identify gaps in claims processing; communicate trends and contract issues to management.
• Prepare comprehensive narratives and visual aids for leadership presentations.
• Coordinate workflows across departments, ensuring compliance with regulations.
• Develop policies and quality assurance measures to improve operational efficiency.

• Minimum of 5 years experience in healthcare claims reporting and processing.
• Advanced SQL coding and Excel skills for creating insightful reports and dashboards.
• Strong knowledge of Medicaid and Medicare guidelines, ICD‑10, CPT, HCPCS, CMS guidelines, Encoder Pro.
• Bachelor’s Degree in Computer Science, Mathematics, Statistics, Engineering (Master’s preferred).
• Excellent written and verbal communication skills.
• Ability to work independently with high productivity.

• Education:
  
  Bachelor’s Degree required (Master’s preferred).
• Minimum 3–5 years of business intelligence and analytics experience.
• Familiarity with medical terminology and coding systems.
• Proficiency in MS Excel, SQL, Tableau, Access.
• Strong communication and independent work capabilities.

Benefits include Medical, Dental, Vision, Life Insurance, Health Savings Account, Paid Time Off.