Senior Claims Analyst II

POSITION SUMMARY/RESPONSIBILITIES          
Acts as Claims department resource to coordinate, analyze, and improve departmental performance. Identifies areas for improvement, documents business processes, researches best practices, compiles information and assists process owners to implement change and monitor performance.  Responsible for providing project coordination through research, data collection and analysis to identify areas for increased operational efficiency, productivity and accuracy. Interacts with other Community First Health Plans, Inc. (Community First) departments. Helps ensure that systems, processes and reports enable the Claims department to meet internal and external benchmarks.

EDUCATION/EXPERIENCE    
High school diploma required. Five (5) years claims experience is required. One to two (1-2) years supervisory experience preferred. Medicaid, Medicare and Commercial claims experience is required. Three (3) or more years’ experience in project coordination in a managed care environment is preferred. Proficiency in Word, Excel, and Powerpoint, is required. Experience with the Cognizant QNXT core operating system is highly desirable.