Case Analyst IV

The Case Analyst IV will be a part of a team supporting development and implementation of case analysis work for reconciliation of data from the health insurance exchanges. 

 

Key Responsibilities:

 

The Analyst is responsible for efficient and timely hands-on troubleshooting, remediation, coordination, escalation, tracking and management of complex consumer enrollment disputes. Also responsible for conducting research, workflow investigations, business procedures and making recommendations for improvement to all aspects of the casework adjudication process.  

 

• Identifying and solving customer information and processing problems  

• Applying triage, research, collaboration, and technical knowledge to resolve transaction and processing issues  

• Analysis of discrepancies in the eligibility reconciliation process for multiple stakeholders  

• Serving as a subject matter expert regarding the Health Insurance Marketplace  

• Provide day-to-day guidance to assigned team members when appropriate  

• Work with technical and development team to resolve identified issues in a timely manner  

• Review documented training material for accuracy and assist with end user training and support  

• Responsible for continuous process improvement of the reconciliation process.  

• Provide content to and for collaboration with training staff on training stakeholders on triaging transactions and the reconciliation process  

• Process 834 file submissions through Advanced Resolution  

• Undertake any additional duties as assigned by Manager  

 

Required minimum qualifications: 

• Bachelor’s Degree or equivalent OR 4 years’ relevant experience in lieu of degree.
• 2 years’ experience with federal data or projects (including but not limited to agencies such as CMS, IRS, DOD, VA, SSA or another federal agency).  
• Must be a US Citizen.

 

Candidates that do not meet the required qualifications will not be considered.

 

Preferred qualifications: 

 

• Experience with Affordable Care Act    
• Strong written and oral communication skills    
• Advanced customer service telephone skills and the willingness to make outbound and receive inbound telephone calls    
• Proficiency in Microsoft Word, Excel, Power Point, SharePoint    
• with Federal contracts desired    
• Experience with 834 enrollment transaction process desired   

 

 

Provides IT and healthcare services to government agencies.