Jobs at Trend Health Partners

Lead healthcare data analysis and quality efforts across claims, pharmacy, and enrollment data. Translate business needs into technical requirements, build complex queries, recommend process and data improvements, manage projects, and mentor team members while liaising between operations, R&D, and IT.

Analyze medical and pharmacy claims to identify, validate, and recover overpayments for payer clients. Validate algorithms, research trends and policies, resolve disputes, document processes, support quality review, train analysts, and collaborate with management to improve recovery and workflow efficiency.

Review remittances, EOBs, and account detail to identify and resolve underpaid hospital claims. Analyze payments against contract terms, prepare appeals, follow up with payers, document root causes and trends, and collaborate with internal teams to improve processes while meeting recovery and accuracy KPIs.

Work with operations, IT, and client teams to manage business applications, schedules, SFTP accounts, and automated reports. Perform data imports/exports, cleansing, QA reporting, trend analysis, and process improvements while maintaining client communication and meeting productivity goals.

The Claims Analyst I will identify and analyze claim overpayments for health insurance clients, ensuring accurate processing and recovery while collaborating with team members and management to innovate solutions.

Design and execute test strategies for AI/ML models and agent-driven workflows. Validate model accuracy, reliability, and data integrity; build automated test frameworks; integrate testing into CI/CD; identify AI risks like bias and hallucinations; collaborate cross-functionally to improve reliability and resolve production issues.