Claims Quality Assurance Data Analyst

MS ACSC Management Services Inc is hiring a Claims Quality Assurance Data Analyst to develop statistically valid sampling methods and support claims audit objectives. The role analyzes trends and error rates, builds and maintains claims audit reports, and provides actionable insights through statistical analysis.

Responsibilities:

• As a Claims Quality Assurance Data Analyst, you will be responsible for developing and implementing statistically valid sampling methodologies, including designing random samples and calculating optimal sample sizes based on staffing constraints, desired confidence intervals, and acceptable error rates. Additionally, it supports audit objectives by conducting significance testing, identifying trends, quantifying error rates, and delivering actionable insights through advanced statistical analysis
• You’ll identify and analyze trends to present to peers and managers
• You’ll design highly complex reports regarding claims audit data to track Audit Quality, Productivity, Trends and Opportunities along with developing reports to track new initiatives, annual performance goals, and provide analysis for recent results
• Subject matter expert on external audit system. Liaison with vendor and other Business units such as Claims, and Data Analytics on matters of audit and reporting
• You’ll maintain reports to ensure accurate data is reported for claims department goals
• You have functional knowledge and expertise on audit system applications. Participates in internal/external training opportunities and supports training for other members of the team for proper use of system
• You’re highly organized and able to work on multiple projects and ad-hoc requests each week, prioritize the various tasks for each project, communicate effectively with the progress made during the week or explain the challenges that are impacting a deadline and estimate when that project can be delivered
• You’ll be a liaison with vendor to ensure accuracy and appropriateness of basic user profile data and licensing for audit system and support applications

Requirements:

• experience in a traditional data analytics and Tableau reporting environment
• the ability to learn new methodologies, databases, and analytical tools
• excellent Tableau and SQL skills
• advanced skills in using Microsoft Excel and PowerPoint
• extensive experience with Python and Jupyter Notebooks
• the ability to analyze, organize and shift priorities to meet the needs you your manager/supervisor
• Tableau/SQL certification is a plus