> Markdown version of [/jobs/ext/2628554-financial-operations-analyst-lead-data-mining-overpayment-and-operations-payment-integrity-wgs-claims](https://www.wearedevelopers.com/jobs/ext/2628554-financial-operations-analyst-lead-data-mining-overpayment-and-operations-payment-integrity-wgs-claims). Every page supports `.md` or `Accept: text/markdown`. Links point to the HTML versions so they work for humans too. Agent guide: [/agents.md](https://www.wearedevelopers.com/agents.md).

---

# Financial Operations Analyst Lead- Data Mining Overpayment and Operations/Payment Integrity- WGS Claims

- **Company:** Elevance Health
- **Location:** Mason, OH, United States
- **Experience:** Expert
- **Contract:** Permanent contract
- **Skills:** Data Analysis, Client Server Models, Data Mining, Relational Databases, Decision Support Systems, Mainframes
- **Published:** August 6, 2026
- **Apply:** https://dejobs.org/x/x/E641B106F3254C339916F614998674C2/job/

## About the Role

* Requires a BA/BS in accounting or finance and a minimum of 5 years' experience in a finance/health insurance field capacity and experience with relational databases and mainframe and client server report writers; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities, and Experiences:

 * Project management experience
 * Experience working post-pay reviews, validation, and recovery processes in the healthcare industry
 * Experience managing multiple projects in various stages to completion
 * Experience with medical billing guidelines, and regulations
 * Experience with medical coding systems such as ICD, CPT, and HCPCS
 * WGS claims processing experience
 * Experience in payment integrity or recovery operations, including leakage analysis
 * Knowledge ofpricing outcomes, and recovery/concept tools (e.g., PICM, ECM, ACR, CI&W).

## Description

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

As a part of the Data Mining Overpayment and Operations team, the Financial Operations Analyst Lead is responsible for analyzing data and providing new processes, system enhancements and technical solutions to complex business issues. Leads and coaches staff. Manages workflow and oversees day-to-day department responsibilities. May conduct operational meetings with staff. Assists management in establishing work goals.

How you will make an impact:

 * Develops and executes complex data analysis.
 * Develops strategic report applications from Finance systems.
 * Provides decision support and procedural input to ensure that processing efficiency does not compromise internal control mechanisms.
 * Interfaces with IT as needed to document and track any needed system enhancements.
 * Assists in the implementation of Data Science models within the Finance organization.
 * Utilizesclaims expertise to explain business needs to technical partners.
 * Represents department in cross functional and executive meetings.
 * Uses discretion in making independent decisions.
 * Provide direction and guidance to team members, lead efforts on complex projects, and serve as a subject matter expert for the team.


## Related Videos

- [Data Science on Software Data](https://www.wearedevelopers.com/videos/162-data-science-on-software-data)
- [Data Science in Retail](https://www.wearedevelopers.com/videos/586-data-science-in-retail)
- [Cloud as the new mainframe: why the cloud hype does not reflect the dev reality](https://www.wearedevelopers.com/videos/797-cloud-as-the-new-mainframe-why-the-cloud-hype-does-not-reflect-the-dev-reality)
- [Anomaly Detection - Using unsupervised Machine Learning for detecting anomalies in customer base](https://www.wearedevelopers.com/videos/6-anomaly-detection-using-unsupervised-machine-learning-for-detecting-anomalies-in-customer-base)
- [".Net is too slow" was not an option](https://www.wearedevelopers.com/videos/100176-net-is-too-slow-was-not-an-option)
- [Data Mining Accessibility](https://www.wearedevelopers.com/videos/802-data-mining-accessibility)

## Related Articles

- [Data Analyst Salary in the UK](https://www.wearedevelopers.com/magazine/278-data-analyst-salary-in-the-uk)
- [Data Analyst Salary in Switzerland](https://www.wearedevelopers.com/magazine/276-data-analyst-salary-in-switzerland)
- [Data Analyst Salary Germany](https://www.wearedevelopers.com/magazine/277-data-analyst-salary-germany)
- [Data Analyst Salary Austria](https://www.wearedevelopers.com/magazine/275-data-analyst-salary-austria)
- [Data Engineer Salary UK](https://www.wearedevelopers.com/magazine/253-data-engineer-salary-uk)
- [Best Paying Jobs in Technology](https://www.wearedevelopers.com/magazine/256-best-paying-jobs-in-technology)