Compliance & Regulatory Reporting Analyst - Corporate Claims

• →Provides operational support for Medicare and Electronic Data Interchange (EDI)-related processes, ensuring timely and accurate completion of critical business activities.
• →Monitors and manages incoming Medicare and EDI work, including communications, referrals, errors, rejections, and other requests requiring follow-up or resolution.
• →Reviews claims-related data errors and rejections, investigates underlying issues, and works with appropriate business partners to identify and implement solutions.
• →Analyzes incoming work and data to identify recurring issues, trends, patterns, and opportunities to improve operational processes.
• →Communicates with claims professionals and other business partners regarding data quality issues, EDI errors, Medicare-related matters, and required corrective actions.
• →Applies knowledge of claims processes and business operations to troubleshoot issues, determine root causes, and independently resolve problems when appropriate.
• →Develops and maintains reports and metrics to communicate trends, recurring issues, workload, and other operational findings to stakeholders.
• →Collaborates with claims divisions, business units, and internal partners to ensure work is completed accurately and in accordance with established guidelines and expectations.
• →Escalates complex or recurring issues and provides clear information and analysis to support timely resolution and business decisions.
• →Performs other duties as assigned.

• Education: Bachelor’s degree in Business Administration, Insurance, Risk Management, Analytics, or a related field, or equivalent experience.
• Experience: Generally, a minimum of 3 years of related experience. Property and casualty insurance experience is highly preferred. Experience in commercial claims, workers' compensation, liability, claims operations, or supporting claims professionals is preferred. Prior Medicare or EDI experience is beneficial but not required.
• Scope of Job/Qualifications: Provides operational and analytical support for critical Medicare and claims EDI processes. Demonstrates strong analytical and problem-solving skills with the ability to review information, identify patterns and trends, investigate errors, and determine root causes. Exhibits the ability to independently manage incoming work, prioritize responsibilities, take ownership of issues, and escalate when appropriate. Knowledge of property and casualty claims processes, regulatory reporting, or claims operations is preferred. Demonstrates strong communication and collaboration skills when working with claims professionals, business units, and other internal stakeholders. Ability to gather and analyze data, develop meaningful reporting, and communicate findings and trends that support operational effectiveness and continuous improvement.

This job is non-exempt in Washington.