Job Details

A company is looking for an Analyst, Claims Quality.Key ResponsibilitiesAudit claim data for Medicare Part D, Medicaid, and Exchange lines of business to validate their accuracyAssist with post-implementation monitoring to ensure adjudication-related fixes/enhancements are functioning as expectedCollaborate with Technical Operations Business Analysts and Product Managers to manage process changes, including defining requirements and executing test plansRequired QualificationsBachelor/Associate Degree in a business-related field or equivalent combined education and experience preferred1 - 3 years of related work experience, preferably in pharmaceutical claims adjudication systems or health plan organizationsParticipation in and support for compliance program objectivesAbility to interact cooperatively and respectfully with other employees