The Data Integration Specialist will analyze, develop and enhance all new and existing interfaces for claim batch file and real-time data integration. The person in this role will serve as a subject matter expert for healthcare claims analysis utilizing both technical expertise and business insight. This role provides analytical support to internal and external customers on various projects, conducts detailed claims analysis and ad-hoc reporting as prioritized by management. This person in this role will spend time working independently, as part of a broader team, and will focus on specific deadlines while providing exceptional client support.

• Identify data requirements to integrate new data sources and perform technical analytics to confirm data integration results meet or exceed defined expectations
• Contribute to the creation and development of new user interfaces and layouts
• Recommend data efficiencies and usage across data platforms, including relational databases
• Review current processes 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
• 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
• Provide 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 promote and participate 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
• Produce, validate and deliver regularly scheduled reports on a timely basis
• Identify all data issues and coordinate a resolution with the respective client team
• Set appropriate expectations with internal and external clients while cultivating an image of professionalism and excellence

• Bachelor's degree or higher in a technical, computer science, or math discipline and 3+ years of relevant experience
• 2+ years working with large volume medical claim files, including data design and transformation
• 2+ years working with relational databases and SQL (Oracle and ANSI preferred)
• 2+ years working with Microsoft suite (Outlook, Excel, Word)
• Working knowledge of Java (or comparable open systems programming language development experience)
• Working knowledge of Excel (Pivot Tables, Macro's, V Lookups, queries, advanced written formulas, VBA)
• Strong organizational skills with an attention to detail and accuracy
• Desire and capacity to learn new concepts and software
• Strong analytical and problem-solving ability
• Excellent written and verbal communication skills
• Ability to properly and professionally handle confidential information
• Ability to work well independently and in a team environment
• Ability to handle multiple tasks, prioritize them and meet required deadlines

 Preferred Skills

• Experience with Red Hat Decision Manager a plus
• Experience with Agile methodologies a plus
• Experience with standard industry coding systems, data elements and transactions, such as CPT, ICD-10, HCFA-1500, UB04, X12, and HL7 a plus
• Experience with XML and real-time processing systems a plus
• Knowledge of healthcare claims processing platforms a plus
• Knowledge of healthcare claims editing systems for correct coding a plus
• Experience in a HIPAA-regulated environment a plus

Job Demands:

• This is a remote role and can be located anywhere in the continental US
• Ability to occasionally travel as needed for team collaboration and special projects
• Flexibility and willingness to participate in the work processes of an international organization, including conference calls scheduled to accommodate global time zones (Team typically works an Eastern Time Zone schedule) 

Mental Requirements:

• Communicating with others to exchange information
• Assessing the accuracy, neatness, and thoroughness of the work assigned

Physical Requirements and Working Conditions:

• Remaining in a stationary position, often standing or sitting for prolonged periods
• Repeating motions that may include the wrists, hands, and/or fingers
• Must be able to provide a dedicated, secure work area
• Must be able to provide high-speed internet access/connectivity and office setup and maintenance

Base compensation ranges from $80,000 to $105,000. 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.

Date of posting: 8/16/2024 

Applications are assessed on a rolling basis. We anticipate that the application window will close on 10/16/2024, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.

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