OpTech

Business Analyst

Detroit, MI, US

Hybrid
Full-time
6 days ago
Save Job

Summary

Job Title: Business Analyst Why work at OpTech? OpTech is a woman-owned company that values your ideas, encourages your growth, and always has your back. When you work at OpTech, not only do you get health and dental benefits on the first day of employment, but you also have training opportunities, flexible/remote work options, growth opportunities, 401K and competitive pay. Apply today! To view our complete list of openings, please visit our website at www.optechus.com. QUALIFICAITONS: Top 3 Required Skills/Experience: * CMS Knowledge * Data Reconciliation and file management * Good Communication Required Skills/Experience: Medicare Advantage Enrollment Expertise: * Minimum 2-4 years of direct experience with Medicare Advantage Enrollment processes * Experience with CMS MAPD, MA and PDP standalone enrollment/disenrollment regulations, enrollment mechanisms, Late Enrollment Penalty (LEP) and Low-Income Subsidy (LIS), Plan Communication User Guide Data Reconciliation and File Management: * Experience with monthly/weekly membership reconciliation * Experience with monthly CMS membership reconciliation (MARx, TRR) * Ability to analyze discrepancies, manage large datasets and track resolution through internal reporting tools * Knowledge of CMS thresholds and compliance timelines for discrepancy resolution * Understanding of required documentation and timelines for retroactive processing and case development Operational Process Improvement: * Ability to identify operational gaps, define root causes, and implement process improvements Regulatory Compliance and Audit Support: * Experience supporting internal and CMS program audits and Compliance reporting Technical and Reporting Skills: * Intermediate experience of Microsoft Programs with Excel (Pivot tables), Word, Outlook, OneNote Communication and Knowledge Dissemination: * Effective written and verbal communication skills OpTech is an equal opportunity employer and is committed to creating a diverse environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, status as a parent, disability, age, veteran status, or other characteristics as defined by federal, state or local laws. https://www.optechus.com/eeo_self_identification/

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