Forensic Data Analyst, Specialist
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Forensic Data Analyst, Specialist plays a pivotal role in advancing our products and services by shaping solution design and supporting strategic decision-making. Collaborates closely with engineers, clinical experts, payment professionals, and business operations leaders to develop reporting and analyze large-scale healthcare claims and clinical datasets. Generates new analytic content aimed at ensuring claims are paid accurately. Leverages advanced coding, analytic reporting, and predictive modeling to uncover actionable insights that drive innovation and improve outcomes across the organization. ESSENTIAL JOB RESPONSIBILITIES & KEY PERFORMANCE OUTCOMES: Work cross functionally to identify opportunities for leveraging company data to drive business solutions. Mine and analyze data from healthcare claim databases to drive optimization and improvement of product development, sales, marketing techniques, and business strategies. Design and develop business intelligence reporting suite for internal and external consumption. Author new analytic content aimed at ensuring health plans pay accurate and reasonable amounts for claims submitted on behalf of their members. Partner with Data Science and Engineering to develop custom complex SQL queries and algorithms to apply to data sets. Partner with Data Science and Engineering to create predictive modeling to support business reporting and decision making. Coordinate with different functional teams to implement models and monitor outcomes. Develop processes to monitor and analyze model performance and accuracy of results.
Qualifications
Minimum of 10 years experience manipulating data sets and building statistical models through SQL, and more advanced technologies. Minimum of 7 years experience with healthcare data and standard UB/HCFA claim fields. Experience using and developing in enterprise level business intelligence tools (e.g. PowerBI, Sigma, Tableau, Domo).
Requirements
Bachelor's degree in business or healthcare/related field (preferred). Excellent written and verbal communication skills for coordinating across teams and with customers. Experience partnering with Data Science teams to ideate algorithms and models, using statistical computer languages (SQL, Python, R) to manipulate data and generate insights from large data sets. Experience working in project management tools (Jira, Confluence) employing proficiency in time management abilities. Strong problem-solving skills with an emphasis on product development. Drive to learn and master new technologies and techniques. Experience building, and delivering, compelling presentations in PowerPoint (or similar). Experience across multiple Payment Integrity product areas (e.g. Edits, Data Mining, Coordination of Benefits, SIU, etc).
Benefits
The US base salary range for this full-time position is: $146,910.00 - $220,366.00. The specific salary offered to a candidate may be influenced by a variety of factors including but not limited to the candidate’s relevant experience, education, and work location. Please note that the compensation details listed in US role postings reflect the base salary only, and does not reflect the value of the total rewards compensation.
Company Description
Lyric is an AI-first, platform-based healthcare technology company, committed to simplifying the business of care by preventing inaccurate payments and reducing overall waste in the healthcare ecosystem. Enabling more efficient use of resources to reduce the cost of care for payers, providers, and patients. Formerly ClaimsXten, is a market leader with 35 years of pre-pay editing expertise. Recognized as 2025 Best in KLAS for Pre-Payment Accuracy and Integrity. HI-TRUST and SOC2 certified. Apply tot his job Apply To this Job