The Senior Data Analyst – UHC Claims Platforms is a domain focused analytics role responsible for analyzing, validating, and interpreting healthcare claims data across UnitedHealthcare claims platforms such as UNET, COSMOS, CSP, and Facets. This role acts as a bridge between claims operations, analytics, and automation teams, ensuring that analytical outputs, dashboards, validation datasets, and AI models are grounded in real world claims processing logic and policy intent.

This role is critical in initiatives related to claims automation, first pass adjudication, rework reduction, quality improvement, and AI driven decisioning

Key Responsibilities

Claims Domain Analytics

Perform deep dive analysis of medical and behavioral health claims data across UNET and COSMOS platforms.

Understand and interpret end to end claims lifecycle, including intake, edits, pends, denials, adjustments, rework, and final adjudication.

Analyze claim outcomes in relation to benefit configuration, policy rules, provider contracts, and member eligibility.

Support analysis for first pass claims,



auto adjudication, rework scenarios, and appeals.

Data Validation & SME Enablement

Validate datasets used for analytics, dashboards, and AI/ML model training against actual platform behavior.

Identify gaps between policy intent and system execution by analyzing claim outcomes across platforms.

Act as a claims SME for analytics, data science, and engineering teams, ensuring correct interpretation of UNET/COSMOS data elements.

Support UAT and pilot evaluations for claims automation and AI initiatives by validating decision logic and outputs.

Analytics & Reporting

Build and maintain analytical datasets, metrics, and dashboards related to claims volume, quality, turnaround time, and auto adjudication performance.

Analyze trends and patterns in claims data to identify leakage, quality issues, and automation opportunities.

Support leadership reporting with accurate, explainable, and audit re

📌 Data Analyst (India)
🏢 Sparix Global
📍 India