Case Analyst

1 month ago

Houston, United States Dunhill Professional Search Full time

Come Join Our Team

The 1095-A Project supports the Center for Medicaid Medicare Services (CMS) by performing case analysis and reconciliation of data from the health insurance exchange. This work is essential in ensuring that consumers who receive their health coverage through the Federally Facilitated Marketplace (FFM) can accurately file their taxes and properly reconcile any tax credits they received to help offset the cost of health insurance.

What is the position?

The Case Analyst II plays a significant role on a fully remote team supporting case analysis and reconciliation of data from the health insurance exchange. As a Case Analyst II, you will be part of a team empowered to collect and reconcile data from several proprietary data sources and subsequently tasked with the responsibility to follow defined standard operating procedures to remediate cases for both consumers and health insurance issuers. It is essential that each Case Analyst II be able to work independently, maintaining the confidentiality of the information they encounter. A Case Analyst II must be flexible and engaged to meet daily expectations and adapt to any changes regarding casework. Furthermore, it is imperative that a successful Case Analyst II candidate be proactive, exercise good judgment, and demonstrate great initiative, as most of the cases they will be troubleshooting and resolving will be unique in nature and will necessitate extreme attention to detail.

What will I get to do?

As a Case Analyst II, you will have the opportunity to utilize your data analysis experience and skills for research, remediation, case management, and troubleshooting to support American consumers who get their health insurance through the FFM. You will also get to showcase your exceptional customer service skills when speaking with consumers via a cloud-based telephony solution to gather additional information needed to properly adjudicate their case as well as inform them of the outcome of their case. You will also be a contributor to workflow investigations, business procedures, and process improvements. You will be trained over a two-week instructor-led virtual training course followed by a one-week job shadow. You will be expected to perform your duties in a dedicated secure area within your residence. As a Case Analyst II you will work within a coordinated team but will be individually responsible to appropriately triage, adjudicate​, and when necessary, escalate consumer dispute cases requiring advanced subject-matter expertise. You will be able to select one of five eight-hour shifts that all fall between the hours of 8:00 AM and 8:00 PM Eastern Time Monday through Friday. Analysts completing 30 days of employment and remaining in good standing will receive a bonus. Analysts who stay for the duration of the assignment and remain in good standing will receive a second bonus.

What qualifications do I need?

  • Bachelor's Degree or equivalent OR 4 years of relevant experience in lieu of degree.
  • Experience following defined processes or assignments.
  • Must be a US Citizen or Authorized to work in the US (if not a citizen) and a resident of the US for at least 3 years within the last 5 years.

What additional characteristics will help me thrive?

  • Proficient in the use of MS Office including Word, Excel, PowerPoint, and Outlook
  • Any experience with health insurance case review is highly desirable
  • Experience with complex data analytics and advanced problem solving
  • Able to work in a fast-paced environment
  • Able to remain engaged in a remote environment
  • Good written and oral communication skills
  • Able to work in a deadline-driven environment
  • Able to work overtime as required
  • Leadership may assign additional duties within the scope of the project.

Due to Federal contract requirements candidates must be US Citizens and reside in the continental US

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