Medicare Analyst - Corporate Claims

Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow.

At Great American, we value diversity and recognize the benefits gained when people from different cultures, backgrounds and experiences work collaboratively to achieve business results. We are intentionally focused on fostering an inclusive culture and know valuing diversity is an essential leadership quality. Our goal is to create a workplace where all employees feel included, empowered and enabled to perform at their best.

Our Corporate Claims department is creating an operations team to support all of aspects of Medicare compliance from Section 111 reporting to MSP conditional payment recovery. Working knowledge of basic Medicare reporting concepts, procedures and processes is required. The ideal candidate must be curious, willing to invest time to dig deeper, able to apply root cause analysis concepts and promote process standardization.

We are seeking a Medicare Analyst to join our Corporate Claims department! This position will be located in either our Cincinnati, OH or Windsor, CT office and will operate on a hybrid schedule.

Essential Job Functions and Responsibilities

• Participates in planning and coordinating projects.

  • Prepares and maintains project plans, budgets and staffing requirements.

  • Tracks progress. Identifies and participates in resolving obstacles.

• Provides general administrative support to project staff. Tasks may include:

  • Prepares routine to moderately complex correspondence, memoranda, agendas, status reports, summaries, request for proposal (RFP’s) etc.

  • Facilitates logistics such as scheduling meetings, conference rooms, conference calls, etc.

  • Takes meeting minutes and action items during meetings and performs basic follow-up.

  • Prepares charts, graphs, presentations and/or tables of a moderately complex nature.

  • Collects, compiles and analyzes moderately complex information to be included in reports and presentations.

• Facilitates communication with project staff, stake holders and key resources.

• Builds and maintains strong divisional and intra-company relationships as well as an understanding of the business/functional unit and organization.

• Demonstrates working knowledge of department policies and procedures, as well those of the organization.

• Performs other duties as assigned.

• Manage RREs, Section 111 file responses and working with CMS Contractors to resolve technical issues.

• Receives and completes tasks associated with accurate data capture, reporting claims and other Medicare activities.

• Tracks and logs all relevant Medicare activities such as the open debt report, pre-CPN and conditional payment process.

• Utilizing features in MSP Navigator to gather relevant reports for distribution and escalating alerts and negative trends.

• Completes analysis of payment summary form as issued by Medicare in the Demand appeal process.

• Prepares response packages to submit to Medicare in a timely manner.

• Perform data clean up as needed.

Job Requirements

• Education: Bachelor’s degree or equivalent.

• Field of Study: Business or related field.

• Experience: Generally, 1 to 3 years of related experience.

Additional Job Description

Scope of Job: Performs work under moderate supervision. Familiar with standard concepts, practices and procedures. Demonstrates competency with various business systems and applications (word processing, spreadsheets, database, presentation, etc.) used to perform job junctions. Works on assignments of moderate technical complexity.

Physical Requirements

• Requires prolonged sitting.

• Requires continuous use of computer.

• May lift, carry, push, or pull objects up to 10 lbs.

• Requires regular and predictable attendance.

Business Unit:

Benefits:

Compensation varies by role, position level, and location. Individual pay is influenced by skills, education, training, certifications, experience, and the role's scope and complexity, along with business needs.

We offer a competitive Total Rewards package, including medical, dental, and vision plans starting on day one, PTO, paid holidays, commuter benefits, an employee stock purchase plan, education reimbursement, paid parental leave/adoption assistance, and a 401(k) plan with company match. These benefits are available to eligible full-time and part-time employees.

Your recruiter can provide more details about our total rewards and specific compensation ranges during the hiring process.