Medicare Advantage and DSNP Claims Analyst - Remote

Overview

The Medicare Advantage and DSNP Claims Analyst is responsible for analyzing and reporting on Medicare Advantage and D-SNP claims to ensure compliance and support operational decisions.

In Short

• Analyze Medicare Advantage and D-SNP claims data.
• Monitor key performance indicators (KPIs) for compliance.
• Perform data validation and create reports.
• Identify trends and recommend actions based on data analysis.
• Collaborate with various internal departments for data integration.
• Support audit processes related to claims compliance.
• Assist in implementing new health plan products.
• Ensure compliance with regulatory requirements.
• Conduct quality assurance procedures.
• Work remotely from most US states.

Requirements

• Bachelor's Degree or equivalent experience.
• 2-3 years of experience in medical claims processing or data analysis.
• Experience with Medicare and Massachusetts Medicaid.
• Knowledge of SQL and data visualization tools.
• Proficiency in Microsoft Office Suite.
• Project management skills are a plus.
• Ability to analyze statistical data.
• Strong communication skills.
• Detail-oriented with problem-solving abilities.
• Ability to work collaboratively in a team environment.

Benefits

• Competitive base pay and comprehensive benefits.
• Career advancement opportunities.
• Recognition programs for contributions.
• Flexible work environment.
• Support for professional growth.