About the role
Responsibilities:
- Perform data quality validation across RCM datasets (Charges, Payments, Adjustments, Denials, A/R).
- Conduct transaction-level reconciliation between PMS/EHR and downstream systems.
- Identify and resolve data discrepancies, missing data, and inconsistencies.
- Develop and execute SQL queries for validation and root cause analysis.
- Validate data transformations, mappings, and business rules.
- Perform trend analysis and anomaly detection on key RCM metrics (Denial %, AR Days, Collections).
- Collaborate with cross-functional teams to define validation rules and acceptance criteria.
- Maintain data quality dashboards, logs, and audit trails.
- Support client onboarding and data validation cycles.
- Document data issues, RCA, and remediation steps.
- Build reusable SQL-based validation scripts and frameworks for scalable DQA.
Requirements:
- 4-6 years of experience in Data QA / Data Validation, preferably in the Healthcare RCM domain.
- Strong understanding of RCM workflows: Billing, Coding, Payments, Denials, and Accounts Receivable.
- Hands-on expertise in SQL (joins, aggregations, validation queries, performance tuning).
- Experience working with large-scale, transaction-level healthcare datasets.
- Strong analytical thinking and problem-solving skills with high attention to detail.
- Experience with ETL testing, data validation frameworks, or data QA processes.
- Ability to interpret business metrics and translate them into data validation logic.
Preferred Qualifications:
- Experience with data warehousing/data lake environments (AWS, Azure, or equivalent).
- Familiarity with tools like Athena, Redshift, Snowflake, or similar.
- Exposure to data quality tools, automation frameworks, or scripting (Python is a plus).
- Understanding of HIPAA compliance and healthcare data security standards.