Compliance & Regulatory Reporting Analyst - Corporate Claims
Core
Provides operational and analytical support for Medicare and Electronic Data Interchange (EDI) processes within corporate claims operations.
Role type
Compliance & Regulatory Reporting Analyst
Builds
Reports and metrics on claims data quality, EDI errors, and operational trends
Domain
Insurance (Property & Casualty) + Healthcare Compliance (Medicare)
Deliverable
dashboards & analysis
Required skills
Claims operations knowledge, Medicare process knowledge, EDI data handling, data analysis, root cause investigation, report development, stakeholder communication
Preferred skills
Property and casualty insurance experience, commercial claims experience, workers' compensation experience, liability claims experience, regulatory reporting knowledge
Technologies
EDI systems, claims data platforms
Responsibilities
Monitor and manage incoming Medicare and EDI work including errors and rejections, review claims data errors and investigate underlying issues, analyze data to identify recurring issues and trends, develop and maintain reports and metrics for stakeholders, communicate data quality issues and corrective actions to business partners, troubleshoot issues and determine root causes, collaborate with claims divisions to ensure accurate work completion
Seniority
Mid-level, hands-on IC
