Apply on Employer Site

PurpleLab · 20 hours ago

Payer Data Specialist

United States

Full-time

Remote

Entry, Mid Level

2+ years exp

PurpleLab is seeking a detail-oriented Payer Data Specialist to drive their mission of transforming healthcare insights through advanced data solutions. In this pivotal role, you will serve as the Payer Data Subject Matter Expert while managing and enhancing healthcare payer and insurance plan datasets.

Computer Software

Responsibilities

Serve as the company’s Subject Matter Expert in healthcare payer information, managing a comprehensive dataset of over hundreds of insurance payers and tens of thousands of insurance products/plans

Apply healthcare payer knowledge to identify and resolve data discrepancies, ensuring accuracy and completeness of payer profiles, plan data, and claims matching crosswalks

Develop and maintain data quality standards specific to healthcare payer information

Monitor end-to-end data workflows for the ingestion, processing, exception resolution, and delivery of PurpleLab’s payer data assets

Review data for accuracy, completeness, and consistency

Lead comprehensive analysis and integration of healthcare datasets from diverse sources including claims data, public records, and third-party vendors

Identify trends and anomalies in payer data that impact PurpleLab’s claims warehouse operations

Collaborate with product management and technical teams to identify data quality issues and implement solutions

Contribute to the development of data validation rules and quality control processes

Stay current with healthcare payer market trends, including mergers and acquisitions, rebranding, and market entrances/exits

Maintain awareness of evolving payer data sources, regulations, compliance standards, and best practices in healthcare data management

Share insights about the payer data landscape with cross-functional teams

Qualification

Healthcare data managementSQLData quality standardsClaims filing processesHealthcare payer knowledgeData management toolsPythonRSoft skills

Required

Bachelor's in healthcare management, data science, or a related field

2+ years healthcare data management experience, preferably with a focus on insurance claims and payer data management

Understanding of the complex landscape of health insurance payers, issuers, self-funded groups, TPAs and PBMs

Strong understanding of healthcare markets such as government programs (traditional Medicare, Medicare Advantage, Medicaid) and commercial (group, individual, exchange)

Proficiency with standard data management tools and IDEs, including writing SQL queries and familiarity with common data tools (SQL, Excel, report builders)