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Forensic Data Analyst, Specialist
Posted 1 year ago

This description is a summary of our understanding of the job description. Click on ‘Apply’ button to find out more.

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.

  • Collaborates closely with engineers, clinical experts, payment professionals, and business operations leaders to develop reporting and analyze large-scale healthcare claims and clinical datasets.
  • Generates new analytic content aimed at ensuring claims are paid accurately.
  • 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:

  • Work cross functionally to identify opportunities for leveraging company data to drive business solutions.
  • Mine and analyze data from healthcare claim databases to drive optimization and improvement of product development, sales, marketing techniques, and business strategies.
  • Design and develop business intelligence reporting suite for internal and external consumption.
  • Author new analytic content aimed at ensuring health plans pay accurate and reasonable amounts for claims submitted on behalf of their members.
  • Partner with Data Science and Engineering to develop custom complex SQL queries and algorithms to apply to data sets.
  • Partner with Data Science and Engineering to create predictive modeling to support business reporting and decision making.
  • Coordinate with different functional teams to implement models and monitor outcomes.
  • Develop processes to monitor and analyze model performance and accuracy of results.

Qualifications

  • Minimum of 10 years experience manipulating data sets and building statistical models through SQL, and more advanced technologies.
  • Minimum of 7 years experience with healthcare data and standard UB/HCFA claim fields.
  • Experience using and developing in enterprise level business intelligence tools (e.g. PowerBI, Sigma, Tableau, Domo).

Requirements

  • Bachelor’s degree in business or healthcare/related field (preferred).
  • Excellent written and verbal communication skills for coordinating across teams and with customers.
  • 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.
  • Experience working in project management tools (Jira, Confluence) employing proficiency in time management abilities.
  • Strong problem-solving skills with an emphasis on product development.
  • Drive to learn and master new technologies and techniques.
  • Experience building, and delivering, compelling presentations in PowerPoint (or similar).
  • Experience across multiple Payment Integrity product areas (e.g. Edits, Data Mining, Coordination of Benefits, SIU, etc).

Benefits

  • The US base for this full-time position is:
  • 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.
  • 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.

  • Enabling more efficient use of resources to reduce the cost of care for payers, providers, and patients.
  • Formerly ClaimsXten, is a market leader with 35 years of pre-pay editing expertise.
  • Recognized as 2025 Best in KLAS for Pre-Payment Accuracy and Integrity.
  • HI-TRUST and SOC2 certified.

Status

Accepting Applications

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