Who We Are

Ready to create a healthier world? We are ready for you! Personify Health is on a mission to simplify and personalize the health experience to improve health and reduce costs for companies and their people. At Personify Health, we believe in offering total rewards, flexible opportunities, and a diverse inclusive community, where every voice matters. Together, we’re shaping a healthier, more engaged future.

Ready to Lead Complex Healthcare Data Integrations That Power Enterprise Excellence?

We're seeking a strategic, technically adept professional who can serve as technical and analytical lead for managing complex healthcare claims data integrations across multiple platforms and partners. As our Senior Claims Integration Specialist, you'll oversee the end-to-end lifecycle of claims ingestion, transformation, and validation while mentoring team members and optimizing integration workflows.

What makes this role different:

✓ Technical leadership: Configure, design, and optimize integration workflows while leading root-cause analysis for data anomalies

✓ Mentorship opportunity: Guide junior team members on best practices in claims data management and automation

✓ Cross-platform expertise: Ensure data quality, compliance, and operational stability across Personify's entire claims ecosystem

✓ Strategic impact: Combine technical proficiency with strategic mindset to enhance process efficiency, scalability, and accuracy

What You'll Actually Do

Lead carrier partnerships: Serve as primary liaison with healthcare carriers to establish and maintain data exchange partnerships while communicating and enforcing universal data specifications.

Manage data ingestion: Collaborate on analysis of inbound healthcare claims data feeds to identify and triage validation or data quality issues using SQL and transformation logic.

Optimize integration workflows: Map carrier-specific data fields into company's universal data model while implementing ingestion processes ensuring data integrity and compliance with internal standards.

Troubleshoot complex issues: Understand and troubleshoot ingestion pipelines, resolving data quality issues and ingestion failures while diagnosing root causes of data anomalies.

Ensure system accuracy: Verify claims data is accurately processed and routed to all relevant internal systems including client servicing platforms, analytics tools, and operational dashboards.

Implement quality controls: Execute robust data validation, reconciliation, and quality control processes while monitoring ingestion performance and proactively resolving discrepancies.

Maintain comprehensive documentation: Create and maintain requirement documentation including business rules, file mapping, and transformation process specifications for all inbound claims files.

Collaborate strategically: Partner with product, operations, technology, data engineering, and architecture teams to support downstream use cases and optimize database structures.

What You Bring to Our Mission

The educational foundation:

• Bachelor's or Master's degree in Health Informatics, Information Systems, Business/Statistics/Information Science, or related field
• 3+ years experience in healthcare data integration, claims processing, or payer-provider data exchange

The technical expertise:

• Strong understanding of healthcare claims formats (EDI 837, NCPDP, proprietary formats) and wide variety of claims formats and coding standards (CPT, ICD, DRG)
• Strong SQL skills with ability to write and tune complex queries against large-scale datasets
• Proven experience managing external partnerships and internal cross-functional teams
• Familiarity with data warehousing, ETL tools, and cloud-based data platforms is plus

The strategic competencies:

• Data architecture mastery: Design and optimize data models to support scalable ingestion and integration of healthcare claims data
• Schema translation expertise: Translate complex or varying carrier-specific schemas into normalized structures aligned with enterprise data standards
• Cross-functional collaboration: Work effectively with carriers and internal departments to ensure claims data is structured for downstream applications
• Industry standards knowledge: Knowledge of industry standard specifications such as FHIR, HL7, and EDI preferred

The professional qualities:

• Excellent communication and project management skills
• Self-motivated with critical thinking and problem-solving abilities
• Strong understanding of data governance, master data management (MDM), and data quality frameworks preferred
• Proven ability to bridge technical and business domains to deliver data-driven solutions
• Experience with claims data reconciliation and migration projects preferred
• Experience working in or with analytics-focused organizations, data consultancies, or enterprise data platforms preferred

Why You'll Love It Here

We believe in total rewards that actually matter—not just competitive packages, but benefits that support how you want to live and work.

Your wellbeing comes first:

• Comprehensive medical and dental coverage through our own health solutions (yes, we use what we build!)
• Mental health support and wellness programs designed by experts who get it
• Flexible work arrangements that fit your life, not the other way around

Financial security that makes sense:

• Retirement planning support to help you build real wealth for the future
• Basic Life and AD&D Insurance plus Short-Term and Long-Term Disability protection
• Employee savings programs and voluntary benefits like Critical Illness and Hospital Indemnity coverage

Growth without limits:

• Professional development opportunities and clear career progression paths
• Mentorship from industry leaders who want to see you succeed
• Learning budget to invest in skills that matter to your future

A culture that energizes:

• People Matter: Inclusive community where every voice matters and diverse perspectives drive innovation
• One Team One Dream: Collaborative environment where we celebrate wins together and support each other through challenges
• We Deliver: Mission-driven work that creates real impact on people's health and wellbeing, with clear accountability for results
• Grow Forward: Continuous learning mindset with team events, recognition programs, and celebrations that make work genuinely enjoyable

The practical stuff:

• Competitive base salary plus that rewards your success
• Unlimited PTO policy because rest and recharge time is non-negotiable
• Benefits effective day one—because you shouldn’t have to wait to be taken care of

Ready to create a healthier world? We're ready for you.

No candidate will meet every single qualification listed. If your experience looks different but you think you can bring value to this role, we'd love to learn more about you.

Personify Health is an equal opportunity organization and is committed to diversity, inclusion, equity, and social justice.

In compliance with all states and cities that require transparency of pay, the base compensation for this position ranges from $68,000 to $85,000. Note that compensation may vary based on location, skills, and experience. This position is eligible for 10% target bonus/variable compensation as well as health, dental, vision, mental health and other benefits.

We strive to cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive. Personify Health is committed to driving Diversity, Equity, Inclusion and Belonging (DEIB) for all stakeholders: employees (at each organization level), members, clients and the communities in which we operate. Diversity is core to who we are and critical to our work in health and wellbeing.

#WeAreHiring #PersonifyHealth

Beware of Hiring Scams: Personify Health will never ask for payment or sensitive personal information such as social security numbers during the hiring process. All official communication will come from a verified company email address. If you receive suspicious requests or communications, please report them to talent@personifyhealth.com. All of our legitimate openings can be found on the Personify Health Career Site.