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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.
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Collaborates closely with engineers, clinical experts, payment professionals, and business operations leaders to develop reporting and analyze large-scale healthcare claims and clinical datasets.
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Generates new analytic content aimed at ensuring claims are paid accurately.
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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:
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Work cross functionally to identify opportunities for leveraging company data to drive business solutions.
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Mine and analyze data from healthcare claim databases to drive optimization and improvement of product development, sales, marketing techniques, and business strategies.
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Design and develop business intelligence reporting suite for internal and external consumption.
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Author new analytic content aimed at ensuring health plans pay accurate and reasonable amounts for claims submitted on behalf of their members.
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Partner with Data Science and Engineering to develop custom complex SQL queries and algorithms to apply to data sets.
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Partner with Data Science and Engineering to create predictive modeling to support business reporting and decision making.
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Coordinate with different functional teams to implement models and monitor outcomes.
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Develop processes to monitor and analyze model performance and accuracy of results.
Qualifications
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Minimum of 10 years experience manipulating data sets and building statistical models through SQL, and more advanced technologies.
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Minimum of 7 years experience with healthcare data and standard UB/HCFA claim fields.
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Experience using and developing in enterprise level business intelligence tools (e.g. PowerBI, Sigma, Tableau, Domo).
Requirements
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Bachelor’s degree in business or healthcare/related field (preferred).
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Excellent written and verbal communication skills for coordinating across teams and with customers.
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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.
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Experience working in project management tools (Jira, Confluence) employing proficiency in time management abilities.
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Strong problem-solving skills with an emphasis on product development.
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Drive to learn and master new technologies and techniques.
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Experience building, and delivering, compelling presentations in PowerPoint (or similar).
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Experience across multiple Payment Integrity product areas (e.g. Edits, Data Mining, Coordination of Benefits, SIU, etc).
Benefits
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The US base for this full-time position is:
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The specific 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.
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Please note that the details listed in US role postings reflect the base only, and does not reflect the value of the total rewards .
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.
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Enabling more efficient use of resources to reduce the cost of care for payers, providers, and patients.
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Formerly ClaimsXten, is a market leader with 35 years of pre-pay editing expertise.
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Recognized as 2025 Best in KLAS for Pre-Payment Accuracy and Integrity.
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HI-TRUST and SOC2 certified.