Massachusetts Licensed Claims Analyst

Job Summary

A company is looking for a Medicare Advantage and DSNP Claims Analyst.

Key Responsibilities

• Collect, monitor, and analyze Medicare Advantage and D-SNP Claims reporting for accuracy and compliance
• Perform data validation and create/update claim reports while identifying trends and recommending actions
• Collaborate with internal departments and vendor partners to enhance workflows and support regulatory compliance

Required Qualifications

• Bachelor's Degree required; experience can substitute for degree
• 2-3 years of medical claims processing and/or data analysis experience in the healthcare industry
• Experience with Medicare and Massachusetts Medicaid is required
• Knowledge of relational databases, SQL, and data visualization tools preferred
• Proficiency with Microsoft Office Suite