Under the general supervision of the Manager, Regulatory Reporting, the Analyst is responsible for the continued enhancement of the Regulatory Reporting process through the improvement and completion of existing state mandated reporting requirements while maintaining a high level of accuracy, integrity and timeliness of data reports.
Develops and maintains a complete understanding of all data sources (including, but not limited to the Data Warehouse, the Facets System and the Reports Database) available for reporting.
Completes all regulatory reporting requirements assigned, accurately and meeting all regulatory deadlines.Failure to do so may result in the company incurring financial penalties, decreased satisfaction by client (e.g., expansion plans) and compromised relationship with state or other regulatory agencies.
Performs data verification through trending, benchmarking or other analyses to ensure data integrity.
Maintains electronic and paper documentation supporting the completion of each report for each reporting period within departmental guidelines.
Utilizing team approach, works cooperatively with other staff members, sharing specific technical or business expertise.
Develops and maintains strong knowledge of business practices, claims coding and the managed care industry in general and applies knowledge to determining data and report solutions.
Develops and maintains strong working knowledge of state and other regulatory agency statutory reporting policies and procedures.
Uses independent judgment (with supervisory guidance as necessary or appropriate) to ensure reporting is completed as accurately and efficiently as possible.
Appropriately identifies and researches any issues or problems potentially compromising the accuracy or integrity of the data reported, utilizing on-line help, the Facets system or other reference materials.
Identifies and analyzes data and/or reporting anomalies.Researches, tests and validates results. Provides explanations for variances and changes.Documents agreed upon explanations in "notes to files", copying statutory management.
Communicates with management/stakeholders to determine appropriate courses of action prior to enacting changes in reporting processes.
Experience and education:
Bachelor's degree or equivalent work experience required.
Minimum of 2 years' experience in Data Analysis, Reporting, Claims Reporting, Managed Care or Healthcare environment with working knowledge of business computer programs, applications and systems, database structures and data files required.
Experience with Microsoft Access or other Relational Databases required
Familiar with Microsoft Office Products (e.g., Excel, Word, etc.)
Strong written and verbal communication skills.
Proven analytical and problem solving skills.
Strong attention to detail as demonstrated in the accuracy and quality of the work produced.
Amerihealth Caritas Health Plan