The Data Integration Specialist 1 develops, enhances, and provides insight for data integration and serves as a subject matter expert for healthcare claims analysis utilizing both technical expertise and business acumen. This role also provides consultative analytical support to internal and external customers on various projects and conducts detailed claims analysis, assists in model development, assists in statistical analysis, and ad-hoc reporting as prioritized by management. The position communicates the outcomes of analysis to business owners, senior management, and clients in a manner that adds insight and value. This role will spend time working independently, as part of a broader team, and will focus on specific deadlines as well as exceptional client service.

• Identify data requirements to integrate new data sources. Perform technical analytics to confirm data integration meets or exceeds defined expectations.
• Contribute to the development of new user interface.
• Act as company-wide subject matter expert (SME) for data / claims processing of client and internally derived data.
• Recommend data efficiencies and usage across data platforms, including relational and non-relational databases and Hadoop-based data platforms.
• Review current programs for opportunities to improve effectiveness and reduce risks/costs.
• Assist in the development of processes/architecture to combine healthcare claims data into integrated data platforms and promote data integration standards and best practices.

Consulting

• Evaluate data and provide insights and recommendations to stakeholders.
• Partner with internal leaders. Understand corporate and client objectives and contribute to the identification and prioritization of upcoming initiatives.
• Effectively communicate technical / analytic information to business partners.
• Mentor Cotiviti employees regarding data insights and best practices.
• Conduct thorough qualitative and quantitative analysis of medical claims data sets.
• Produce accurate and meaningful ad hoc reports from verbal and written requests.

Other Related Responsibilities

• Actively promotes and participates in process improvement.
• Participate in the design and development of dynamic data quality monitoring tools to preemptively identify defective data.
• Conduct detailed claims analysis and ad-hoc reporting as prioritized by management.
• Produce work that reflects a focus on quality in consideration of the client's (internal and external) needs and qualitative self-review process.
• Produce, validate and deliver regularly scheduled reports on a timely basis.
• Identify all data issues and coordinate a resolution with the prospective client team.
• Special projects (e.g., RFP support) System Upgrades, Re-Platforming, and technology uplift.
• Sets appropriate expectations with internal and external clients while cultivating an image of professionalism and quantitative / qualitative excellence.
• Available for occasional off-hours support for executive team members in the company as required.
• Some travel will be required for this role (occasional to <5%).
• Other duties as assigned or apparent.
• Must have flexibility and willingness to participate in the work processes of an international organization, including conference calls scheduled to accommodate global time zones.
• Must be able to sit and use a computer keyboard and monitor for extended periods.

• Bachelor's degree or higher in technical, computer sciences, or math discipline
• 3+ years working within large volume relational data sets, including data design and transformation (preferably by use of TSQL/PLSQL)
• 1+ years of experience working with large volumes of medical claims data.
• Knowledge of HCFA & UB04 data elements. 
• 1+ years of experience developing in Hadoop with hands-on knowledge of Oozie, Hive and/or Spark
• Advanced knowledge of Excel (Pivot Tables, Macro's, V Lookups, queries, advanced written formulas).
• Organizational skills.
• Attention to detail and accuracy.
• Desire and capacity to learn new concepts and software.
• Strong analytical and problem-solving ability.
• Experience in a HIPAA-regulated environment.
• Excellent written and verbal communication skills.
• Comfortable speaking in front of a group, with clients, and working with physician executives.
• Professional with ability to properly handle confidential information.
• Ability to work well independently and in a team environment.
• Ability to handle multiple tasks, prioriize and meet deadlines. 
• AWS / Cloud experience a plus

Preferred Skills

• Knowledge of healthcare claims processing platforms a plus.
• Knowledge of healthcare claims editing systems for correct coding a plus.
• Experience with Dimensional Modeling a plus.
• Knowledge of systems integration and architecture.

Base compensation ranges from $80,000.00 to $105,000.00. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs.

Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page.

Since this job will be based remotely, all interviews will be conducted virtually. 

Date of posting: 2/20/2024

Applications are assessed on a rolling basis. We anticipate that the application window will close on 4/20/2024, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.

#LI-Remote

#LI-LC1

#senior