Claims Data Analytics - Network Operations jobs in United States
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Stedi · 1 month ago

Claims Data Analytics - Network Operations

positionUnited States
timeFull-time
remoteRemote
seniorityMid, Senior Level

Stedi is a leading programmable healthcare clearinghouse that facilitates essential transactions between healthcare providers and payers. The Claims Data Analytics role involves leveraging data to define key metrics, improve operational efficiency, and enhance customer outcomes within the claims and revenue cycle management processes.

B2BHealth CareInformation Technology
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H1B Sponsor Likelynote

Responsibilities

Define and track RCM health metrics: Develop and maintain metrics such as claim acceptance rates, denial reasons, first-pass resolution rates, payer adjudication times etc. while identifying new measures as payer behavior and customer needs evolve
Analyze payer performance: Track payer-level performance (claim rejections, delay patterns, ERA discrepancies, eligibility response behavior) to surface trends and identify systemic issues impacting customers
Create actionable reporting: Build clear, high-signal dashboards and reports that enable Customer Operations, Payer Operations, and Product teams to proactively detect and resolve issues before customers are affected
Drive claims & RCM insights: Partner with Customer Operations, Sales, and Product to analyze claim flows, denial patterns, payer rules, and reimbursement behaviors that improve troubleshooting and inform product enhancements
Document patterns and requirements: Create and maintain a knowledge base of payer rules, recurring claim errors, eligibility and status bugs, and remittance behaviors to support faster and more accurate triage
Maintain a clear analytics backlog: Own and maintain a structured backlog of analytics needs in Linear, prioritizing requests, scoping work, and communicating progress to cross-functional stakeholders

Qualification

RCM expertiseSQLData visualizationClaims analyticsAI technologiesDocumentation skillsSelf-motivatedCommunication skills

Required

Deep RCM expertise in analyzing healthcare claims, claim status, and payer reimbursement data
Exceptional analytics and documentation skills, treating claims analytics like an engineering discipline
Expert in SQL and fluent in modern visualization tools
Excited about using new AI technologies to improve analysis speed, automate workflows, enhance pattern detection
Ability to create and execute own work, being relentlessly curious and wanting to become an expert in the product and overall operation
Resourceful, self-motivating, self-disciplined, and proactive in getting the job done
Ability to move quickly with urgency, crisp communication, and willingness to escalate or ask for feedback
Detail-oriented, thriving on the details and willing to tackle any task to find success, generate revenue, and improve costs

Company

Stedi

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Stedi is the only API-first healthcare clearinghouse.
dateFounded in 2017
location
New York, New York, USA
people-size51-200 employees
web-link
http://www.stedi.com

H1B Sponsorship

Stedi has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (1)

Funding

Current Stage
Growth Stage
Total Funding
$95.08M
Key Investors
StripeVTF Capital
2024-11-26Series B· $20M
2020-08-18Series B· $50.1M
2019-11-08Series Unknown· $21.28M

Leadership Team

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Zack Kanter
Founder & CEO
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