Remote Claims Processor Jobs in Chelsea, MA (NOW HIRING)

About Cedar Gate Technologies

Cedar Gate Technologies, an IQVIA business, enables payers, providers, employers, and service administrators to excel at value-based care with a unified technology and services platform delivering analytics, care, and payment technology on a single data management foundation. At Cedar Gate, you'll be part of a collaborative, innovative environment where great ideas thrive. We invest deeply in our people through ongoing training, comprehensive benefits, and a strong culture of teamwork, offering the chance to grow your skills while contributing to high impact initiatives for some of the world's most dynamic companies.

Position Summary

As a Senior Data Quality Analyst at Cedar Gate Technologies, an IQVIA business, you will play a critical role in ensuring the accuracy, integrity, and reliability of healthcare data that powers our industry-leading analytics platform. You will work with complex healthcare datasets, including medical claims, pharmacy claims, eligibility, provider, member, and reference data, helping to ensure that clients can confidently rely on the insights generated from our solutions.

In this highly visible role, you will partner with Engineering, Product, Data Operations, Client Support, and offshore teams to validate data, investigate and resolve quality issues, strengthen governance practices, and drive continuous improvement across the data lifecycle. You will have the opportunity to influence data quality strategy, improve processes and automation, mentor team members, and serve as a trusted subject matter expert in healthcare data quality. Your work will directly impact product performance, client satisfaction, and the quality of analytics delivered to healthcare organizations nationwide.

Job Location

Burlington, MA (Boston)

Work Arrangement

Hybrid (3 days in office, 2 remote)

Roles & Responsibilities

• Lead data quality validation efforts across medical claims, pharmacy claims, eligibility, provider, member, and reference data.
• Perform data profiling, reconciliation, ETL validation, anomaly detection, and root cause analysis.
• Design and execute test plans, validation rules, regression testing, and quality control processes.
• Partner with cross-functional teams to investigate data issues, assess business impact, and validate corrective actions.
• Develop complex SQL queries for data analysis, defect investigation, and quality reporting.
• Establish and monitor data quality metrics, KPIs, and governance standards.
• Support data quality tooling, observability, and automation initiatives.
• Mentor Data Quality Analysts and coordinate activities with offshore resources.
• Ensure compliance with HIPAA, data privacy, security, and regulatory requirements.

Experience / Qualifications

• 5+ years of experience in healthcare data analysis, data quality, data operations, or data engineering; 8+ years preferred.
• 3+ years of experience validating U.S. healthcare claims data, including medical, pharmacy/Rx, eligibility, provider, and member data.
• Strong knowledge of healthcare payer data, claims processing, benefit design, coding systems (ICD-10, CPT, HCPCS, NDC), and PBM data concepts.
• Advanced SQL skills and experience with data profiling, reconciliation, and defect analysis.
• Experience with cloud data platforms, data warehouses, ETL validation, and data quality or observability tools.
• Familiarity with Tableau, Power BI, Python, Excel, Jira, or similar tools.
• Strong communication, analytical, problem-solving, and mentoring skills.
• Bachelor's degree in a related field or equivalent experience.
• Preference will be given to those with experience in healthcare analytics, EDI transactions (837/835/834), data governance platforms, client-facing support, and leadership of data quality initiatives.
• To be eligible for this position, you must reside in the same country where the job is located.

IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide. Learn more athttps://jobs.iqvia.com

IQVIA is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable law. https://jobs.iqvia.com/eoe

IQVIA is committed to integrity in our hiring process and maintains a zero tolerance policy for candidate fraud. All information and credentials submitted in your application must be truthful and complete. Any false statements, misrepresentations, or material omissions during the recruitment process will result in immediate disqualification of your application, or termination of employment if discovered later, in accordance with applicable law. We appreciate your honesty and professionalism.