Program Integrity Reporting Analyst

Responsibilities

• Performs research and creates reports to monitor progress of cases in assigned lines of business.
• Makes weekly/monthly/quarterly/annual regulatory reports of assigned lines of business and responds to ad hoc requests.
• Initiates and follows up on reprocessing claims due to FWA audits and investigations.
• Provides claims processing technical support and expertise to team members.
• Audits claims for correct coding issues and identifies potential recoveries or processing errors.
• Maintains the FWA claim inventory and prepares weekly reports as needed.
• Maintains the SIU case tracking system with progress and follow-up actions, including required reporting.
• Utilizes business intelligence and reporting tools such as SQL, SAS Enterprise Guide (EG), MS Access, MS Excel, Tableau, and PowerPoint.
• Extracts and summarizes data from various systems and formats reports into visually effective tools.
• Prepares clear, accurate, timely, and informative statistical and narrative reports containing findings, analysis, conclusions, and recommendations.
• Analyzes existing PI reports and makes recommendations for enhancements.
• Maintains library of available PI reports and archives historical reports and their associated distribution lists.

Requirements

• Bachelor’s Degree required.
• Minimum 3 to 5 years data analysis and reporting experience required.
• Minimum 3 years of SQL, SAS Enterprise Guide (EG), MS Access, MS Excel, Tableau experience preferred.
• Experience in creating, supporting, or writing reports, business correspondence, and technical documents.
• Experience in claims processing, requirement gathering, and documentation.
• Experience in driving projects from initiation through completion and being accountable for results.
• Experience working in a team setting and on assigned project teams.
• Excellent verbal and written communication skills.
• Strong analytical, conceptual, and problem-solving skills.
• Proven ability to manage multiple concurrent tasks/projects.
• Strong work ethic, self-motivated, and self-initiated learner.

Qualifications

• Knowledge of claims processing.
• Experience in driving projects from initiation through completion, and in being accountable for results.
• Experience working in a team setting and on assigned project teams.
• Excellent verbal and written communication skills.
• Strong analytical, conceptual, and problem-solving skills.
• Proven ability to manage multiple concurrent tasks/projects.
• Strong work ethic, self-motivated, and self-initiated learner.

Skills

• SQL, SAS Enterprise Guide (EG), MS Access, MS Excel, Tableau.
• PowerPoint and Visio.

Benefits

• Flexible work solutions including remote options, hybrid work schedules.
• Competitive pay.
• Paid time off including holidays and volunteer events.
• Health insurance coverage for you and your dependents on Day 1.
• Tuition reimbursement.