Regulatory Claims Data Analytics Specialist

Kalepa; Atlanta (GA); On-site; USD 85,000 - 110,000; Full time

Job summary

MSIG USA, the US-based subsidiary of MS&AD Insurance Group, seeks a Claims Compliance Analyst in Atlanta to monitor regulatory requirements across workers' compensation and CMS reporting. You will translate complex regulations into actionable data needs and collaborate with Claims, IT, and external partners to ensure accurate regulatory reporting.

The role emphasizes data analysis, regulatory research, and documentation, with a focus on CMS Section 111 and EDI processes.

Qualifications

• Bachelor's degree or equivalent experience in business, insurance, risk management, or data analytics.
• Experience in insurance claims regulatory compliance or regulatory reporting preferred.
• Knowledge of CMS Medicare Secondary Payer/Section 111 reporting preferred.
• Proficiency with Microsoft Office (Word, Excel, PowerPoint).

Responsibilities

• Monitor, analyze, and ensure adherence to federal and state claim-related regulatory requirements.
• Support CMS Medicare Secondary Payer reporting, including Section 111 reporting.
• Analyze regulatory changes and translate them into clear business and data requirements.
• Assist with regulatory inquiries, data requests, examinations, and reporting.
• Maintain documentation of reporting requirements, deadlines, data elements, and compliance obligations.
• Participate in testing of system changes affecting CMS or EDI reporting.
• Coordinate with Claims, IT, vendors, and stakeholders to resolve CMS data issues.

Skills

Regulatory compliance

Data analysis

CMS reporting

EDI reporting

FROI/SROI reporting

Stakeholder communication

Guidewire experience

Education

Bachelor's degree in business, insurance, risk management, compliance, data analytics

Tools

Guidewire ClaimCenter

Job description

MSIG USA, the US-based subsidiary of MS&AD Insurance Group, seeks a Claims Compliance Analyst in Atlanta to monitor regulatory requirements across workers' compensation and CMS reporting. You will translate complex regulations into actionable data needs and collaborate with Claims, IT, and external partners to ensure accurate regulatory reporting.

The role emphasizes data analysis, regulatory research, and documentation, with a focus on CMS Section 111 and EDI processes.