• Lead exploratory analysis of claims data to identify utilization patterns, anomalies, and potential overpaid or inappropriate claims • Apply deep knowledge of billing rules, coding, reimbursement, and workflows to guide data mining and investigative efforts • Perform reverse engineering of claims outcomes to understand root causes of payment issues and system behaviors • Translate operational and claims insights into clear use cases, concepts, and solution ideas for analytics and product teams • Partner closely with analytics, product, and strategy teams to ensure solutions align with real-world claims operations • Validate data-driven findings against practical claims and payment realities • Clearly communicate insights, risks, and opportunities to both technical and non-technical stakeholders • Support ongoing refinement and scaling of claims monitoring and overpayment detection capabilities