[Hiring] Healthcare Data Analyst / Algorithm Developer @RADcube - A NLogix Company

Role Description

We are seeking a detail-oriented Healthcare Data Analyst / Algorithm Developer to support healthcare data analysis, coding logic development, and program integrity activities for medical coding, medical record review, and billing compliance functions. This role is responsible for:

• Analyzing claims and encounter data.
• Developing and refining data-driven algorithms and review logic.
• Identifying coding and billing patterns.
• Producing actionable insights to support clinical, operational, and financial decision-making.

The ideal candidate brings strong SQL and data analysis skills, a solid understanding of healthcare reimbursement data, and working knowledge of CPT, HCPCS, and ICD-10 coding concepts. This individual will work closely with coding, clinical, and audit teams to:

• Translate business rules and policy requirements into queries, logic models, audit targeting methodologies, dashboards, and analytic outputs.
• Exhibit strong analytical thinking, attention to detail, and the ability to interpret healthcare data in support of audit readiness, payment integrity, and compliance monitoring.

Qualifications

• Bachelor’s degree in data analytics, health information management, informatics, public health, healthcare administration, statistics, computer science, or a related field preferred.
• At least 2 years of experience in healthcare data analysis, claims analysis, payment integrity, program integrity, revenue cycle analytics, or related work preferred.
• Strong experience with SQL required, including writing complex queries, joining large datasets, aggregating results, and validating outputs.
• Working knowledge of medical coding concepts, including CPT, HCPCS, and ICD-10, strongly preferred.
• Experience working with healthcare claims or encounter data required; Medicaid experience strongly preferred.
• Familiarity with healthcare billing, reimbursement, documentation review, audit support, or compliance monitoring preferred.
• Experience developing logic models, analytic rules, dashboards, or automated reporting solutions preferred.
• Proficiency in Microsoft Excel required; experience with data visualization and reporting tools preferred.
• Strong analytical, critical thinking, problem-solving, and organizational skills.
• Ability to communicate technical findings clearly to non-technical audiences.
• Strong attention to detail and ability to manage multiple datasets, priorities, and deadlines.
• Ability to work independently and collaboratively in a fast-paced environment.

Requirements

• Ability to translate complex healthcare policy and coding requirements into clear analytic logic.
• Strong understanding of claims structures, provider billing behavior, and reimbursement data relationships.
• Experience identifying outliers, trend shifts, and risk indicators through targeted data analysis.
• Ability to prepare concise, decision-ready summaries of findings for operational and leadership audiences.
• Comfort working in an environment that combines data analytics, coding review, audit support, and compliance monitoring.
• Experience supporting initiatives related to payment integrity, fraud waste and abuse detection, utilization review, or billing compliance is strongly preferred.

Company Description