Claims Analyst

Myers and Stauffer LC is a certified public accounting and health and human services consulting firm, specializing in audit, accounting, data management and consulting services to government-sponsored health and human services programs (primarily state Medicaid agencies, and the federal Center for Medicare & Medicaid Services).

We have 45+ years of experience assisting our government clients with complex health care reimbursement and provider compliance issues, operate 20 offices and have over 900 associates nationwide.

At Myers and Stauffer, you will have a career that is rewarding while also supporting our state and federal government health and human services clients that focus on those in need.

We are committed to providing our employees with professional growth and development opportunities, a diverse, dynamic, challenging work environment, and a strong and visionary leadership team.

What We Offer :

• Health, Dental, and Vision insurance along with other competitive employee benefits
• Vacation time, sick time, paid holidays, and two floating holidays
• Paid Parental Leave and available support resources
• 401K with company matching for eligible employees
• Tuition reimbursement, referral bonuses, paid volunteer community service time, mentor program, and a variety of other employee programs and perks
• A combination of technical and leadership development training at each career milestone
• Up to six counseling sessions per year for eligible employees through our Employee Assistance Program

The Claims Analyst will work with a team of other analysts and accountants in performing examinations of pharmacy and medical health care data.

The Claims Analyst will review the pharmacy / medical data to complete required analyses and to determine compliance with existing regulations.

Essential Functions

• Conduct desk and on-site reviews of pharmacy and medical data of health plans
• Conduct research in order to determine billing and reimbursement compliance with relevant Medicare or other government program regulations
• Conduct all phases of the examination including planning and research, risk assessment, fieldwork, reporting of findings, and other procedures as required
• Prepare working papers to document scope and findings of the examination in accordance with relevant standards
• Demonstrate excellence in communication skills, data analysis, reporting, and process improvement
• Maintain security and confidentiality of all protected health information when analyzing material
• Maintain thorough electronic documentation in centralized tracking application
• Interface with team in multiple different office locations
• Additional responsibilities as assigned

Requirements

• Bachelor's degree required
• One or more years of experience in claims related analysis / healthcare experience preferred
• Experience working for a Prescription Benefit Manager (PBM), health plan, or pharmacy claims processor is beneficial
• Proficient use of applicable software programs, including Microsoft Office suite (specifically Excel and Word)
• Strong analytical and problem solving skills
• Well organized with a high degree of accuracy and attention to detail
• Must be able to manage multiple deadlines and prioritize assignments
• Strong verbal and written communication skills
• May require up to 25% overnight travel.

The Team :

Myers and Stauffer takes pride in the welcoming and collaborative culture we have throughout our offices. For this position, the employee will report to one of our Managers or Senior Managers on the Managed Care engagement team.

Work Style :

Our general business hours are Monday through Friday 8am-5pm, but can vary based on business needs. Dependent on performance, our in-office associates are eligible for a hybrid work schedule after their initial 90-day training period.

As a company, we are always willing to discuss potential flexibility that an employee may need to better suit their work-life wellbeing.

Typical Interview Process :

• Phone Screen with a Recruiter
• In person or remote interview with the hiring manager & team
• Hiring decision and job offer

We understand that changing or learning a new industry can discourage strong candidates from applying. Myers and Stauffer is committed to investing in your career development and providing the necessary resources to help you succeed.

Please do not hesitate to apply, as you may be the right fit for this position or another position we have open.

The annual salary target for this job in this market is $60,000-$70,000. The specific compensation for this role will be determined based on the education, experience, and skill set of the individual selected for this position.

The compensation above is not representative of an employee's total compensation. Beyond income, should you become a full-time team member, you have access to comprehensive medical and dental insurance, retirement savings, life and disability insurance, health care and dependent care reimbursement accounts, certification incentives, education assistance, referral program and much more.

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