Business and Data Analyst - Compliance

Summary: As a Business and Data Analyst in the Compliance department at GeoBlue, the incumbent will use a combination of data interpretation, analysis, and coordination and consolidation of internal data and external data obtained from vendors and partners to accurately produce required federal and statutory regulatory reports with an emphasis on claims data analysis and interpretation, as well as some internal reporting, required by GeoBlue and/or our insurance company fronting partners. In addition, the incumbent will review, coordinate, and help implement internal procedures and processes of GeoBlue and its partners that are impacted by changes mandated by state or federal regulations.

Responsibilities:

• Collaborate with business users to extract business requirements for reporting needs.
• Document business requirements.
• Collect, analyze, and interpret complex claims data from various sources to ensure business requirements are met.
• Coordinate and lead data integration from outside vendors ensuring data is collected and reported on time.
• Generate reports from single or multiple systems.
• Process confidential data and information according to guidelines.
• Assist in the development of a strategy for improvements in the data collection and reporting for GeoBlue's future compliance requirements and growth.
• Proactively assist with the identification of training and development opportunities.
• Develop business requirements for key projects and collaborate with cross functional partners on assessment and implementation of projects.
• Analyze/document workflows, make recommendations for enhancements and support the implementation and measurement of new processes/procedures, including any changes mandated by state or federal regulations.
• Other duties as assigned.

• Bachelor's degree with 1-2 years of experience; or 4-5 years of related work experience.
• In-depth knowledge of medical claims terminology, MDC, ICD-10, CPT, HCPC codes and coding along with and the processing of medical claims.
• Preferred knowledge of insurance industry regulations and compliance, including mental health parity analysis and reporting.
• Ability to read insurance documents and federal/state regulations to determine the content required to be disclosed.
• High attention to detail for proofreading documents and researching state and federal guidelines.
• Critical thinking skills and proficiency in data analysis.
• DBA-related skills and/or knowledge of statistics or advanced analytics.
• Proficient with common data collection and analytics tools such as SQL, SalesForce, Qlik preferred.
• Expertise in Microsoft Office products and other desktop publishing software as necessary to produce documents. Experience with software such as Salesforce, SharePoint preferred.
• Excellent verbal and written communication skills are needed to effectively work with employees, customers, vendors, and other departments to represent the company and its goals and interests.
• Ability to learn and master other software, as needed, to perform the job duties.
• Ability to make decisions and support them with documentation.
• Employee is required to have at minimum an internet speed of 75 Mbps (standard high-speed internet access).

• Flexibility to work in an office and/or at-home, remote office environment.
• Schedule flexibility is occasionally necessary in this position. Individual may be required to attend key business/departmental meetings and/or perform certain business critical job functions outside of normal working hours.
• Physical Demands: Must be able to communicate internally and externally through receiving and responding to auditory and visual methods.