POSITION SUMMARY
The Senior Claim Data Analyst is responsible for the implementation, management, and maintenance of various claim data and processes. The position acts as a subject matter expert on claim data and is responsible for increasing Allied’s claim automation initiatives. The role will execute, manage, and audit claim data processes and workflows. The position will analyze data, create custom reporting, and make recommendations to management.
ESSENTIAL FUNCTIONS
- Manages the implementation and ongoing maintenance of various claims data processes with the organization.
- Demonstrates a strong understanding of Allied’s business and claim data requirements.
- Serves as Allied’s subject matter expert and main point of contact for claim, provider maintenance, and other data processes and questions.
- Addresses and resolves claim data issues with vendors and trading partners.
- Works with Allied’s programming team to test and make changes to existing claim data processes and workflows.
- Researches, analyzes, and resolves claim data related problems or questions by gathering and analyzing information.
- Develops new workflows and drives claim automation initiatives.
- Collaborates with multiple departments within the organization to gather information, conduct comprehensive assessments, and determine claim data requirements.
- Confers with appropriate personnel to ensure newly implemented claim data procedures are functioning successfully and at high quality.
- Reviews existing claim data processes, procedures, workflows, and applications to propose enhancement initiatives.
- Develops custom reporting using Power BI, SQL server queries, Excel, and Access
- Develops and implements quality assurance protocols and completes detailed audits.
- Provides key business insights for the organization to drive results and support strategic initiatives.
- Provides executive summaries and process improvement recommendations to management.
- Other duties as assigned.
EDUCATION
- Bachelor’s degree required (Computer Science or Information Systems degrees preferred)
EXPERIENCE AND SKILLS
- 5+ years of related business and claims data experience
- QicLink experience preferred.
- Microsoft Excel – Advanced
- Microsoft Access – Intermediate to Advanced
- Communication Skills – excellent written and verbal
- High attention to detail and accuracy required.
COMPETENCIES
- Accountability
- Communication
- Action Oriented
- Timely Decision Making
- Building Relationships/Shaping culture
- Customer Focus
PHYSICAL DEMANDS
- This is an office environment requiring extended sitting and computer work
WORK ENVIRONMENT
The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.