Role Summary
We are looking for a Senior Data Analyst with 10+ years of experience at the intersection of SQL, medical coding (CPT-4, ICD-10), and healthcare revenue cycle operations. This is a senior individual contributor role requiring deep technical expertise, strong domain knowledge, and a proven record of translating healthcare data into measurable financial and clinical impact.
Key Responsibilities
• Develop and maintain MySQL/MSSQL stored procedures, batch-scripted reporting systems, and data pipelines supporting revenue cycle operations ($3M+ annually).
• Analyze healthcare claims data segmented by provider, service type, and time period to drive clinical and financial decisions.
• Apply expert-level CPT-4, ICD-10, and HCPCS coding knowledge — including modifier usage, surgical coding, fee schedules, and carrier-specific rules.
• Manage EDI transaction workflows: ANSI ASC X12N 837P, 835, 277CA, and 999 to maximize clean claim rates and reduce denials.
• Consult with practice leadership on CPT utilization strategy, revenue projections, and coding compliance.
• Support HIPAA-compliant data architecture and HL7 middleware integrations between practice management and billing systems.
• Deliver executive-ready dashboards and parameterized reporting tools enabling timely leadership decisions.
Required Qualifications
• 10+ years in Data Analysis within healthcare or medical billing environments.
• Expert-level SQL — MySQL/MSSQL stored procedures, database design, performance tuning, and automation.
• 10+ years of hands-on CPT-4 and ICD-10 coding — procedure/surgical coding, modifiers, and insurance carrier rules.
• EDI experience: ANSI ASC X12N 837P, 835, 277CA, 999 transaction sets.
• HIPAA compliance knowledge applied to data handling and system architecture.
• Demonstrated revenue impact through data-driven solutions ($1M+ preferred).
• Bachelor''s degree in Computer Science, Mathematics, Business, or equivalent experience.
Preferred Qualifications
• HL7 middleware integration experience for patient data exchange and lab requisition workflows.
• AWS cloud experience: instance deployment, VPC/firewall configuration, encrypted data transfers.
• Multi-client medical practice management or revenue cycle consulting background.
• Prior senior leadership (COO, Director) in a medical software or billing organization.