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Pro90 ProblemsSQL + Python

Health Claims SQL & Python Interview Questions

Healthcare analytics teams process insurance claims, clinical outcomes, and cost data for fraud detection, care utilization measurement, and compliance reporting. These SQL and Python challenges are modeled after work at UnitedHealth, CVS Health, Cigna, Humana, Elevance Health, Kaiser Permanente, BCBS, Centene, Molina Healthcare, and more. Master claims processing analysis, member risk scoring, cost benchmarking, and regulatory reporting.

Health Claims

90 total problems

SQL45
Python45
Top Companies Hiring in Health Claims

Questions are relevant for real analytics problems data science teams solve at these companies.

UnitedHealth
UnitedHealth
CVS Health
CVS Health
Centene
Centene
Humana
Humana
Elevance Health
Elevance Health
Cigna
Cigna
Kaiser Permanente
Kaiser Permanente
HCSC
HCSC
Molina Healthcare
Molina Healthcare
Independence Blue Cross
Independence Blue Cross
BCBS
BCBS
Change Healthcare
Change Healthcare
Health Catalyst
Health Catalyst
Inovalon
Inovalon
Veradigm
Veradigm
MultiPlan
MultiPlan
Cotiviti
Cotiviti
Verisk
Verisk
IBM
IBM
Epic Systems
Epic Systems

Difficulty Distribution

Easy

16

18% of problems

Medium

37

41% of problems

Hard

33

37% of problems

Expert

4

4% of problems

What You'll Practice

Claims processing analysis
Fraud detection patterns
Care utilization metrics
Provider performance
Member retention
Cost trend analysis
Diagnosis code grouping
Risk score modeling

Topics Covered

21 topics
SQL· 9
aggregationbasic queries filteringcleaning transformdate timejoinsscenario sqlset operationssubqueries cteswindow functions
Python· 12
eda statisticsfeature engineeringpandas aggregationpandas applypandas basicspandas cleaningpandas datetimepandas filteringpandas mergingpandas reshapingpandas scenariopandas window

All Problems90 total

Open in editor
01
Active PPO Plans With Prescription CoveragePro
SQLEasy
02
Approved High-Value ClaimsPro
SQLEasy
03
Surgical Procedures Requiring Prior AuthPro
SQLEasy
04
Active Providers Accepting New PatientsPro
SQLEasy
05
Enrolled Primary Subscribers by StatePro
SQLEasy
06
Claims With Patient and Provider DetailsPro
SQLMedium
07
Claim Line Items With Procedure NamePro
SQLMedium
08
Patient Claims With Insurance Plan TypePro
SQLMedium
09
Prior Auth Requests With Procedure and ProviderPro
SQLMedium
10
Provider Contracts With Plan NamePro
SQLMedium
11
Denied Claims With Patient and Plan InfoPro
SQLMedium
12
Eligibility Checks With Patient and PlanPro
SQLMedium
13
Total Billed Amount by Claim StatusPro
SQLEasy
14
Average Paid Amount by Place of ServicePro
SQLMedium
15
Claim Count by Provider SpecialtyPro
SQLMedium
16
Denial Rate by Plan TypePro
SQLMedium
17
Total Patient Responsibility by PlanPro
SQLMedium
18
Top Procedures by Total Paid AmountPro
SQLMedium
19
Rank Providers by Claim VolumePro
SQLMedium
20
Top Claim per PatientPro
SQLHard
21
Patient Running Total PaidPro
SQLHard
22
Provider Claim Rank Within SpecialtyPro
SQLHard
23
Claims with Previous Service DatePro
SQLHard
24
Top 2 Line Items per ClaimPro
SQLHard
25
Claims Above Average Billed AmountPro
SQLMedium
26
Providers with Denied ClaimsPro
SQLMedium
27
Patients Above Plan Average Paid AmountPro
SQLHard
28
Active Procedures Never DeniedPro
SQLHard
29
High-Utilization PatientsPro
SQLHard
30
Claims Submitted in Last 90 DaysPro
SQLEasy
31
Average Processing Time by Claim StatusPro
SQLMedium
32
Claims Volume and Spend by Service MonthPro
SQLMedium
33
Patient Enrollment TenurePro
SQLMedium
34
Claims With Cost Tier LabelPro
SQLEasy
35
Providers With Network Status LabelPro
SQLEasy
36
Claims With Payment Ratio CategoryPro
SQLMedium
37
Providers With Claims or ContractsPro
SQLMedium
38
Patients With Claims but No Prior AuthPro
SQLMedium
39
Provider Reimbursement ScorecardPro
SQLHard
40
Plan Financial SummaryPro
SQLHard
41
Prior Auth Approval Rate by ProcedurePro
SQLHard
42
Patient Cost-Sharing BreakdownPro
SQLHard
43
Network Leakage Report by PlanPro
SQLHard
44
Claim Adjudication Pipeline AnalysisPro
SQLHard
45
Provider Contract Utilization AnalysisPro
SQLHard
46
Active Insurance PlansPro
PYTHONEasy
47
Claim Status CountsPro
PYTHONEasy
48
Provider Specialty SummaryPro
PYTHONMedium
49
Procedure Category BreakdownPro
PYTHONMedium
50
High-Value Approved ClaimsPro
PYTHONEasy
51
In-Network Office Visit ClaimsPro
PYTHONMedium
52
Primary Subscribers With Plan InfoPro
PYTHONMedium
53
Denied Claims With High Patient CostPro
PYTHONHard
54
Count Patients by Insurance PlanPro
PYTHONEasy
55
Total Billed Amount by ProviderPro
PYTHONMedium
56
Average Claim Amounts by StatusPro
PYTHONMedium
57
Claim Stats by Place of Service and NetworkPro
PYTHONHard
58
Provider Claims Performance SummaryPro
PYTHONHard
59
Claims With Patient NamesPro
PYTHONEasy
60
Line Items With Procedure DetailsPro
PYTHONMedium
61
Procedures Without Any ClaimsPro
PYTHONMedium
62
Claim Details With Provider and PlanPro
PYTHONHard
63
Full Claim DetailsPro
PYTHONHard
64
Rank Claims by Amount Within PatientPro
PYTHONMedium
65
Running Total Paid per PatientPro
PYTHONMedium
66
3-Month Moving Average Billed per ProviderPro
PYTHONHard
67
Claim Amount Change vs Previous per PatientPro
PYTHONHard
68
Patient Enrollment Year and MonthPro
PYTHONEasy
69
Claim Processing Time in DaysPro
PYTHONMedium
70
Monthly Claims Volume by Claim StatusPro
PYTHONHard
71
Fill Missing Patient Contact InfoPro
PYTHONEasy
72
Normalize Claim Payment RatiosPro
PYTHONMedium
73
Clean and Enrich Patient Claims DataPro
PYTHONHard
74
Pivot Claim Counts by Status and Place of ServicePro
PYTHONMedium
75
Plan Claim Amounts Pivot by Plan Type and Metal TierPro
PYTHONHard
76
Classify Claims by Amount TierPro
PYTHONMedium
77
Patient Risk ClassificationPro
PYTHONHard
78
Compute Claim Payment RatiosPro
PYTHONMedium
79
Claim Amount Quartile BucketingPro
PYTHONHard
80
Time-Based Claim FeaturesPro
PYTHONHard
81
Patient Claims Feature MatrixPro
PYTHONExpert
82
Claim Line Item Feature EngineeringPro
PYTHONHard
83
Claim Amount Descriptive Stats by Place of ServicePro
PYTHONMedium
84
Billed vs Paid Amount Correlation by Place of ServicePro
PYTHONHard
85
Anomalous Claim Amounts (IQR)Pro
PYTHONHard
86
Claims Processing ScorecardPro
PYTHONHard
87
Provider Network Performance ReportPro
PYTHONHard
88
Full Claims Lifecycle ReportPro
PYTHONExpert
89
Insurance Plan Health ClassificationPro
PYTHONExpert
90
Cross-Provider Claims AnalysisPro
PYTHONExpert

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