Description

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

Required Skills & Experience
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
 

Key Skills

Education

Bachelor's degree