Senior Claims Optimizations Analyst

📋 Description

• Proactively uncover friction via data mining of complex claims databases.
• Architect advanced automations: scripts (Python, R, or RPA) for bulk claims.
• Lead AI & prompt engineering: deploy AI to interpret claims and medical records.
• Protect the ecosystem: monitor automated workflows for uptime amid updates.
• Partner cross-functionally: translate blockers into technical requirements for Eng.
• Own end-to-end delivery: manage UAT, deployment, and post-launch monitoring.

🎯 Requirements

• 5+ years in healthcare ops analytics, process engineering, or automation in health plans/TPA.
• Advanced SQL and production-ready Python or scripting using APIs/databases.
• Proven automation frameworks and AI/LLMs experience to solve bottlenecks.
• Payer expertise: claims adjudication systems and routing logic.
• Autonomy: deliver data-backed root causes and working automation tools.
• Nice to have: experience at a high-growth company.

🎁 Benefits

• Health and wellness benefits
• Flexible PTO
• Up to 16 weeks paid parental leave
• Paid holidays
• 401(k) program
• Education reimbursement