The Post Claims Data Analyst will be part of the Program Management team and possess an advanced understanding of fraud evaluation. The analyst will be responsible to take ownership of projects and interact with internal clients to understand their project requirements and perform analysis for Fraud Prevention. The analyst will also be responsible for performing analysis on claims to determine whether the claim was both legitimate and handled properly by other internal departments.
As a secondary function the analyst will provide support to the Program Managers, Analyst(s), and other departments as needed. This will entail supporting created reports and dashboards and the possible gathering of additional data as needed.

The Primary Duties and Responsibilities:

• Research insurance claims to identify set characteristics related to fraudulent behavior
• Logically link existing claims together based on fraud patterns and decision appropriately
• Become a SME on all client billing systems and internal claims systems
• Ensure projects are researched, documented, and completed in accordance with departmental standards
• Understand and stay up to date on all adjuster processes and procedures
• Interact with key stakeholders within Fraud Operations
• Communicate both verbally and in writing a clear and concise summary of findings
• Perform auditing of data in a quick and efficient manner
• Work in multiple billing and administration systems simultaneously

Qualifications:

• Time management and organizational skills
• Exceptional analytical and quantitative skills
• Detail-oriented and strong problem-solving skills
• Communication and collaboration skills to enable work with all levels of the organization
• Strong PC skills including a high proficiency in Microsoft Excel
• Self-motivated individual having the ability to multi-task without missing deadlines
• Professional individual with a strong work ethic and is a demonstrated team player
• Contributes to team effort by accomplishing related results as needed
• High School education required, some college or statistical analysis skills a plus

Certificates, Licenses, Registrations:
This position will require that you hold a valid insurance license. Failure to pass the insurance license exam or an inability to obtain or maintain the required license(s) will result in forfeiture of
the position. If you are not currently licensed, but have taken and failed the insurance licensing exam or have otherwise been unable to complete the licensing application process, you will not be considered for this position

• Research insurance claims to identify set characteristics related to fraudulent behavior
• Logically link existing claims together based on fraud patterns and decision appropriately
• Become a SME on all client billing systems and internal claims systems
• Ensure projects are researched, documented, and completed in accordance with departmental standards
• Understand and stay up to date on all adjuster processes and procedures
• Interact with key stakeholders within Fraud Operations
• Communicate both verbally and in writing a clear and concise summary of findings
• Perform auditing of data in a quick and efficient manner
• Work in multiple billing and administration systems simultaneousl