Medicaid Reinsurance Analyst - Remote in AZ

Blue Cross Blue Shield of Arizona; United States; À distance; USD 60 000 - 90 000; Plein temps

Résumé du poste

Blue Cross Blue Shield of Arizona is seeking a Recoveries Analyst to support Medicaid reinsurance activities. The role focuses on researching and reviewing claims, coordinating with AHCCCS, and leading daily and senior-level tasks within the Recoveries Department.

Two levels (Level 1 and Level 2) describe responsibilities from assisting with routine processes to leading in transplant and catastrophic reinsurance cases, with emphasis on accuracy and timely reimbursement.

Qualifications

• Required High School Diploma or GED; preferred bachelor’s in accounting, business or related field.
• Experience with health plan reinsurance, AHCCCS administration or claims units.
• Knowledge of AHCCCS guidelines and Medicaid reinsurance requirements.
• Proficiency with PMMIS, MedMc and QNXT systems and basic SQL.

Responsabilités

• Assist in day-to-day reinsurance dept tasks; identify and manage transplant and catastrophic reinsurance claims with AHCCCS coordination.
• Process and balance encounters; ensure timely submissions and reimbursements per AHCCCS rules.
• Prepare and review reinsurance reports; support accounting and data warehouse reconciliation.
• Lead by example, motivate teams, and promote process improvements.

Connaissances

PowerPoint

Word

Excel

Communication

Analytical thinking

Team player

Formation

High School Diploma or GED

Bachelor’s degree in accounting, business or related field

Outils

PMMIS

MedMc

QNXT

SQL (Beginner)

Description du poste

Blue Cross Blue Shield of Arizona is seeking a Recoveries Analyst to support Medicaid reinsurance activities. The role focuses on researching and reviewing claims, coordinating with AHCCCS, and leading daily and senior-level tasks within the Recoveries Department.

Two levels (Level 1 and Level 2) describe responsibilities from assisting with routine processes to leading in transplant and catastrophic reinsurance cases, with emphasis on accuracy and timely reimbursement.