Reporting Solutions Consultant I

BCBST BlueCross BlueShield of Tennessee, Inc.; Chattanooga (TN); Remote; USD 70,000 - 90,000; Full time

Job summary

BlueCross BlueShield of Tennessee, Inc. is seeking a Reporting Solutions Consultant I on the Internal Audit team.

You will retrieve, query, and analyze claims data to support audits across the organization, working with claims data tables and reporting tools to fulfill data requests and support the Claims Payment Integrity function. Ideal candidates have hands-on experience with healthcare claims data, knowledge of Facets, familiarity with SQL, and strong analytical skills.

Qualifications

• Hands-on experience querying, retrieving, and analyzing healthcare claims data.
• Knowledge of Facets and familiarity with claims data tables.
• Familiarity with SQL or other comparable data querying and analytical tools.
• Ability to develop queries and extract data to support requests.
• Strong analytical and problem-solving skills.
• Ability to work independently with minimal ramp-up time.
• Interest in developing audit knowledge and using claims data to support audit reviews.

Responsibilities

• Define requirements, analyze, design, enhance, and develop reporting methods to efficiently and effectively fulfill corporate initiatives and planning/development objectives.
• Assist in determining data requirements and Metadata definitions in the data warehouse environment.
• Effectively administer reporting solutions in a rapid application development environment ensuring short term proof of concepts meet long term objectives.
• Maintain technical skill sets across a broad range of software languages, databases and platforms that will be used in the development and production of analyses and reporting solutions.
• Provides significant input to establishment of reporting protocols, tools, and systems development and enhancement.
• Documents and coordinates complex, cross functional analytic and reporting solution test plans.
• Participate in vendor evaluation and selection processes.

Skills

Claims data analysis

SQL

Facets

Data extraction

Independent worker

Audit knowledge interest

Healthcare payer

Education

Bachelor's degree or equivalent

Tools

Facets

SQL

Job description

Reporting Solutions Consultant I

We are hiring a Reporting Solutions Consultant I on the Internal Audit team at BlueCross BlueShield of Tennessee! In this role, you will serve as a key claims data resource for Internal Audit, retrieving, querying, and analyzing claims data that supports audits across the organization. You will work with claims data tables and reporting tools to fulfill audit-related data requests while also providing data and reporting support to the Claims Payment Integrity team. This is an opportunity to combine technical claims expertise with broader business exposure, develop an understanding of audit practices, and help Internal Audit improve how the team accesses and uses claims data to support effective, data-driven reviews.

Ideal candidates for the role will bring: Hands-on experience querying, retrieving, and analyzing healthcare claims data. Knowledge of Facets and familiarity with claims data tables and claims-related systems. Familiarity with SQL or other comparable data querying and analytical tools. The ability to develop queries and extract data to support business and audit requests Strong analytical and problem-solving skills, including the ability to investigate data needs and work through complex or evolving requests. The ability to work independently, understand the business context behind data requests, and become productive with minimal ramp-up time. An interest in developing audit knowledge and using claims data to support audit reviews.

• Hands-on experience querying, retrieving, and analyzing healthcare claims data.
• Knowledge of Facets and familiarity with claims data tables and claims-related systems.
• Familiarity with SQL or other comparable data querying and analytical tools.
• The ability to develop queries and extract data to support business and audit requests.
• Strong analytical and problem-solving skills, including the ability to investigate data needs and work through complex or evolving requests.
• The ability to work independently, understand the business context behind data requests, and become productive with minimal ramp-up time.
• An interest in developing audit knowledge and using claims data to support audit reviews.

• Preferred qualifications: Experience supporting healthcare payer claims reporting, analytics, or audit-related data requests.
• Previous auditing experience or experience providing data and analysis in support of audit activities.
• Experience working with claims oversight, validation, or review functions.

Job Responsibilities

• Define requirements, analyze, design, enhance, and develop reporting methods to efficiently and effectively fulfill corporate initiatives and planning/development objectives.
• Assist in determining data requirements and Metadata definitions in the data warehouse environment.
• Effectively administer reporting solutions in a rapid application development environment ensuring short term proof of concepts meet long term objectives.
• Maintain technical skill sets across a broad range of software languages, databases and platforms that will be used in the development and production of analyses and reporting solutions.
• Provides significant input to establishment of reporting protocols, tools, and systems development and enhancement.
• Documents and coordinates complex, cross functional analytic and reporting solution test plans.
• Participate in vendor evaluation and selection processes.

Job Qualifications

Education Bachelor's Degree or equivalent work experience required. Equivalent experience is defined as 4 years of professional work experience in a corporate environment Experience 3 years - Reporting development and programming experience required.

Skills/Certifications Must have proven analytical and system design skills and demonstrated success in leading large projects or multiple concurrent small to medium projects. In-depth knowledge of systems development life cycle and/or operational maintenance environment Proficient in MicroSoft Office (Outlook, Word, Excel, Access and Powerpoint) Excellent oral and written communication skills.

Number of Openings Available 1 Worker Type: Employee Company: BCBST BlueCross BlueShield of Tennessee, Inc.

BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law. Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page: BCBST's EEO Policies/Notices

BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.

As Tennessee's largest health benefit plan company, we've been helping Tennesseans find their own unique paths to good health since 1945. More than that, we're your neighbors and friends – fellow Tennesseans with deep roots of caring tradition, a focused approach to physical, financial and community good health for today, and a bright outlook for an even healthier tomorrow.

At BCBST, we empower our employees to thrive both independently and collaboratively, creating a collective impact on the lives of our members. We seek talented individuals who excel in a team environment, share responsibility, and embrace accountability.

We're also seeking candidates who are proficient in the Microsoft Office suite, including Microsoft Teams, organized, and capable of managing multiple assignments or projects simultaneously. Additional, strong interpersonal abilities along with strong oral and written communication skills are important across all roles at BCBST. We foster a culture where innovation is encouraged. That includes using AI enabled tools responsibly to support everyday work — guided by proven workflows, templates, and policies. As roles become more advanced, we expect employees to leverage AI more broadly to transform how we serve members.

BCBST is a remote-first organization with many employees working primarily from their homes. Each position within the company is classified as either fully remote, partially remote, or office based. BCBST hires employees for remote positions from across the U.S. with the exception of the following states: California, Massachusetts, New Hampshire, New Jersey, and New York. Applicants living in these states may move to an approved state prior to starting a position with BCBST at their own expense. If the position requires the individual to reside in Chattanooga, TN, they may be eligible for relocation assistance.