About the position
We're looking for a detail-oriented Claims Analyst who thrives on hands-on data work. You'll analyze health, life, and disability insurance claims to uncover trends, identify cost drivers, and support strategic decisions. This is an individual contributor role — expect to spend significant time in Excel and SQL, manage multiple projects independently, and translate complex data into clear, actionable insights.
Responsibilities
• Audit and analyze claims to ensure accurate documentation, appropriate coverage determination, and timely exposure identification.
• Manage all email and phone correspondence with clients and provider agents regarding assigned cases.
• Work with payors to resolve discrepancies and document outcomes.
• Extract and analyze claims data, identifying trends, patterns, and anomalies.
• Conduct root cause analysis on claims cost drivers and utilization patterns.
• Build and maintain Excel models for claims forecasting and trend analysis using pivot tables and advanced formulas.
• Perform financial reconciliation and validate claims processing accuracy.
• Prepare and maintain reporting on open/closed claims, reconciliation status, outstanding risks, and KPIs, flagging significant deviations.
• Identify recurring issues, cost-saving opportunities, and recommend process improvements.
Requirements
• 2-5 years of hands-on experience in claims analysis, healthcare analytics, or financial analysis (insurance sector preferred)
• Experience with health insurance terminology (CPT codes, ICD codes, EOBs, etc.)
• Knowledge of claims adjudication processes and workflows
• Understanding of ERISA regulations and compliance requirements
• Advanced Excel skills including pivot tables, VLOOKUP/XLOOKUP, complex formulas, and data modeling
• Proficiency in SQL for querying databases and manipulating large datasets
• Must be legally authorized to work in the United States without the need for employer sponsorship.
Benefits
• competitive pay
• plenty of PTO
• health care
• 401K matching
• fun employee outings