Elap Services
  • Chesterbrook, PA, USA
  • Full Time


Support development & execution of business analytics.

Duties and Responsibilities                                            

  •  Analyze third party and internal medical claim data to forecast savings and identify trends.
  • Analyze claims to determine appropriate CPT, HCPCS and ICD-10 for accuracy. Research and understand Medicare and policies. Develop and maintain processes for data validation.
  • Enter necessary claims data for analysis as required. Manage internal/external data process flows.  Troubleshoot and resolve complex data processing errors.
  • Compile, analyze and interpret data analyses with guidance from various stakeholders. Prepare analytical reports and develop data visualizations using best practices adhering to internal standards.  Present findings to stakeholders and/or clients directly as needed.
  • Evaluate options and make recommendations to business processes to gain efficiencies and enhance performance. Document issues that affect claims analysis quality, advise team of processing concerns, and recommend approaches for resolution/enhancements.
  • Use advanced analysis techniques to support design, development, and maintenance of user-friendly and efficient business information systems and processes.
  • Identify, assess and incorporate external datasets to support analyses. Communicate data transmittal requirements with third parties (i.e. third-party administrators, data vendors)
  • Perform Project Management for data analysis projects
  • Contribute to development of new analytical processes to optimize the business.
  • Collaborate extensively with IT leads to ensure successful projects and optimized use of resources.
  • Other duties as assigned.

Required Experience and Education

  • Bachelor's degree (preferred in technical or mathematics.) 
  • Master's degree preferred.
  • Prove experience analyzing healthcare claim data sets

Summary of essential job functions

  1. CPT, HCPCS and ICD-10 domain expertise
  2. Understanding of healthcare business.
  3. Applied quantitative analysis experience.
  4. Understanding of computer science fundamentals.
  5. Prior exposure to at least one major programming language. Ability and willingness to learn SQL, R, Excel.
  6. Flexibility, curiosity and persistence.
  7. Excellent organizational skills, with acute attention to detail.
  8. Team experience working closely with business professionals and technical resources to act as a bridge between the two groups (internal / external). Ability to work in fast-paced, dynamic environment.
  9. Microsoft Office proficient.
  10. Healthcare industry / HIPAA regulated data environment experience preferred.
Elap Services
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