Payer Data Specialist - Purplelab : Job Details

PurpleLab is seeking a detail-oriented Payer Data Specialist to drive our mission of transforming healthcare insights through advanced data solutions. In this pivotal role, you'll serve as our Payer Data Subject Matter Expert (SME) while managing, validating, and enhancing our extensive healthcare payer and insurance plan datasets.

Duties and Responsibilities:

Payer Data Management

• Serve as the company's Subject Matter Expert in healthcare payer information, managing a comprehensive dataset of over hundreds of insurance payers and tens of thousands of insurance products/plans.
• Apply healthcare payer knowledge to identify and resolve data discrepancies, ensuring accuracy and completeness of payer profiles, plan data, and claims matching crosswalks.
• Develop and maintain data quality standards specific to healthcare payer information.

Data Operations & Quality Assurance

• Monitor end-to-end data workflows for the ingestion, processing, exception resolution, and delivery of PurpleLab's payer data assets.
• Review data for accuracy, completeness, and consistency.
• Lead comprehensive analysis and integration of healthcare datasets from diverse sources including claims data, public records, and third-party vendors.
• Identify trends and anomalies in payer data that impact PurpleLab's claims warehouse operations.
• Collaborate with product management and technical teams to identify data quality issues and implement solutions.
• Contribute to the development of data validation rules and quality control processes.

Industry Landscape & Innovation

• Stay current with healthcare payer market trends, including mergers and acquisitions, rebranding, and market entrances/exits.
• Maintain awareness of evolving payer data sources, regulations, compliance standards, and best practices in healthcare data management.
• Share insights about the payer data landscape with cross-functional teams.

Qualifications:

Required

• Bachelor's in healthcare management, data science, or a related field.
• 2+ years healthcare data management experience, preferably with a focus on insurance claims and payer data management.
• Understanding of the complex landscape of health insurance payers, issuers, self-funded groups, TPAs and PBMs.
• Strong understanding of healthcare markets such as government programs (traditional Medicare, Medicare Advantage, Medicaid) and commercial (group, individual, exchange).
• Proficiency with standard data management tools and IDEs, including writing SQL queries and familiarity with common data tools (SQL, Excel, report builders).

Preferred

• Experience with claims filing, adjudication, and payment processes, including clearinghouses and claims routing.
• Certifications in data management or healthcare analytics.
• Experience working with software development teams, especially in a healthcare technology startup environment.
• Experience with big data cloud platforms (AWS or Google Cloud) and data scripting (Python/R) a bonus.

What We Offer:

• Impact-Driven Mission: Directly shape healthcare outcomes through data-driven solutions.
• Startup Culture: Collaborative, dynamic environment with significant growth potential.
• Professional Development:
  • Continuous learning opportunities
  • Exposure to cutting-edge data technologies
  • Career advancement in a scaling company

A background check is required for this role.

PurpleLab is an equal opportunity employer and welcomes applications from diverse candidates.