Claim Reporting Analyst, Ops - Emblem Health
Albany, NY 12201
About the Job
• Apply reporting and data analysis best practices in the design, execution, and delivery of informational tools to support the
monitoring of standard claim operations activities.
• Document new, and interpret existing, business requirements for measuring and tracking claim operations performance.
• Transform requirements into actionable, high quality deliverables.
• Work with other Operations areas as needed to provide technical and other support in the development, delivery,
maintenance, and enhancement of analytical reports and analyses.
Principal Accountabilities
• Evaluate informational needs and design, test, build, and execute appropriate database query processes to generate
reports for monitoring claim throughput: receipts, inventory, and processed claims.
• Publish timely deliverables that adhere to established data integrity standards.
• Support rapid implementation of solutions for future claim data requests.
• Build and maintain re-usable query processes that target multiple data sources and are tailored to satisfy routine
requests for claim data.
• Develop and deliver recurring reports and analyses.
• May perform trend and other types of analysis to determine patterns of data.
• Prepare and deliver ad hoc reporting solutions, as needed.
• Maintain documentation library to promote efficient knowledge transfer of data collection strategies and data quality
protocols. May work with other areas to ensure recommended solutions meet business requirements.
• Prepare business requirements for individual database pulls.
• Establish formal checklists of pass/fail criteria for evaluating the quality of deliverables.
• Develop expertise and thought leadership in the areas of business intelligence and reporting.
• Perform research to build, maintain, and enhance industry and technical knowledge.
• Continuously evaluate existing strategies and processes and propose improvements.
• Perform other related tasks as directed or required.
Education, Training, Licenses, Certifications
• Bachelor's Degree, preferably in Business Intelligence, Data Analytics, or related quantitative field of study.
Relevant Work Experience, Knowledge, Skills, and Abilities
• 3 - 5+ years' related work experience in business intelligence or data analytics role. (R)
• 3+ years of experience in a health insurance or healthcare environment. (P)
• Additional experience or specialized training may be considered in lieu of educational requirement. (R)
• Experience with relational database concepts and data access tools: Statistical Analysis Software (SAS); IBM Cognos Analytics;
Oracle SQL Developer. (P)
• Experience with structured query language (SQL). (R)
• Strong organizational skills: time management; planning; prioritizing; and scheduling tasks. (R)
• Strong attention to detail, plus analytical and problem-solving skills. (R)
• Proficient with MS Office (Word, Excel, Access, PowerPoint, Outlook, Teams, etc.). (R)
• Excellent communication skills (verbal, written, presentation, interpersonal). (R)
• Flexibility to work independently and as part of a team. (R)
Additional Information
- Requisition ID: 1000000743_01
- Hiring Range: $52,000-$92,000