Regulatory Reporting Analyst

Your career starts now. We''re looking for the next generation of health care leaders.At AmeriHealth Caritas, we''re passionate about helping people get care, stay well and build healthy communities. As one of the nation''s leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we''d like to hear from you.Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at Responsibilities:Under the general supervision of the Manager, Regulatory Reporting, the Analyst is responsible for the continued enhancement of the Regulatory Reporting process through the improvement and completion of existing state mandated reporting requirements while maintaining a high level of accuracy, integrity and timeliness of data reports.Develops and maintains a complete understanding of all data sources (including, but not limited to the Data Warehouse, the Facets System and the Reports Database) available for pletes all regulatory reporting requirements assigned, accurately and meeting all regulatory deadlines. Failure to do so may result in the company incurring financial penalties, decreased satisfaction by client (e.g., expansion plans) and compromised relationship with state or other regulatory agencies.Performs data verification through trending, benchmarking or other analyses to ensure data integrity.Maintains electronic and paper documentation supporting the completion of each report for each reporting period within departmental guidelines.Utilizing team approach, works cooperatively with other staff members, sharing specific technical or business expertise. Develops and maintains strong knowledge of business practices, claims coding and the managed care industry in general and applies knowledge to determining data and report solutions.Develops and maintains strong working knowledge of state and other regulatory agency statutory reporting policies and procedures.Uses independent judgment (with supervisory guidance as necessary or appropriate) to ensure reporting is completed as accurately and efficiently as possible.Appropriately identifies and researches any issues or problems potentially compromising the accuracy or integrity of the data reported, utilizing on-line help, the Facets system or other reference materials.Identifies and analyzes data and/or reporting anomalies. Researches, tests and validates results. Provides explanations for variances and changes. Documents agreed upon explanations in "notes to files", copying statutory municates with management/stakeholders to determine appropriate courses of action prior to enacting changes in reporting processes.Education/Experience:Bachelor''s Degree or equivalent.Basic working knowledge of business computer programs, applications and systems, database structures and data files required.Basic understanding of Claims Processing/ Clinical Coding and business practices.Ability to appropriately extract and manipulate data from a variety of sources and databases.Strong communication (both written and verbal), analytical and problem solving skills.Excellent organizational skills.Ability to identify issues, research, investigates and document findings.Data Analysis, Reporting, Claims, Managed Care or Healthcare environment required.Proficiency in Microsoft Access, Excel, Word and Power Point.Experience with Microsoft Access or other Relational Databases required.NOTE: Due to COVID-19, Associates are presently working remotely. When Associates are transitioned back to the office, the functions of this position will be performed onsite at our offices located at 3805 West Chester Pike, Newtown Square, 19073. BackShareApply Now

Created: 2021-11-29