Independently manage claims reporting responsibilities across all assigned states and jurisdictions, ensuring required data is reported accurately and on time
Review policy and claims documentation, entering claim and payment data into reporting systems, and maintaining diaries to support timely filings and follow‑up activities
Review state reports for accuracy and compliance, correct errors promptly, and help resolve any inquiries, fines, or penalties that may arise
Serve as a point of contact for EDI‑related issues, provide technical guidance to claims representatives, and stay current on regulatory and industry changes through ongoing learning
Assist with job overviews and training, analyze current workflows, and recommend process improvements to increase efficiency and effectiveness
Consistently demonstrate strong customer service and adherence to audit guidelines

At least 2 years of experience adjusting claims or in claims support
Working knowledge of Medicare compliance and/or workers’ compensation state reporting
3 years of data entry experience
Working knowledge of medical, legal, and insurance terminology
Strong attention to detail with solid analytical and organizational skills
Ability to work independently, manage priorities, and solve problems
Clear written and verbal communication skills, along with basic math skills
Interpersonal skills, including the ability to provide training or guidance to others
Basic proficiency in Microsoft Word and Excel

Medical & Prescription Insurance
Health Savings Account
Dental Insurance
Vision Insurance
Short and Long Term Disability
Flexible Spending Accounts
Life and Accidental Death & Disability
Accident and Critical Illness Insurance
Employee Assistance Program
401(k) Plan with Company Match
Pet Insurance
Paid Time Off. Standard first year PTO is 17 days, pro-rated based on month of hire.
Enhanced PTO may be available for experienced candidates
Bonus eligible based on performance

Compliance Analyst II

Key skills