• Claims Data Analyst

    Job Locations US-IL-Aurora
    Posted Date 2 weeks ago(8/3/2018 12:43 PM)
    # of Openings
    Medical Claims
  • Overview





    Looking for a way to influence the health and healthcare of many?


    If so, we’d love to hear from you! Our mission-driven organization is focused on theTriple Aim - Better Health, Better Healthcare and Lower Costs to individuals and their families who participate in our health plans.


    UNITE HERE HEALTH serves 100,000+ workers and 220,000 covered lives in the hospitality and gaming industry nationwide. Our desire to be innovative and progressive drives us to develop impactful programs and benefits designed to engage our participants in managing their own health and healthcare. Our vision is exciting and challenging. Please read on to learn more about this great opportunity!



    Key Attributes:


    • Integrity – Must be trustworthy and principled when faced with complex situations
    • Ability to build positive work relationships – Mutual trust and respect will be essential to the collaborative relationships required
    • Communication – Ability to generate concise, compelling, objective and data-driven reports
    • Teamwork – Working well with others is required in the Fund’s collaborative environment
    • Diversity – Must be capable of working in a culturally diverse environment
    • Continuous Learning – Must be open to learning and skill development.  As the Fund’s needs evolve, must be proactive about developing new areas of expertise
    • Lives our values – Must be a role model for the Fund’s BETTER Culture and Mission (Better, Engage, Teamwork, Trust, Empower, Respect)



    This position is responsible for analyzing large amounts of data to make recommendations to the business related to benefit design, expense, workflow efficiency and productivity.


    Essential Job Functions:



    • Create ad hoc reports from various databases such as Javelina, Oracle and external data sources such as Microsoft Excel Spreadsheets.
    • Analyze data to trend volumes, expenses and inventory fluctuations.
    • Design, program and produce ongoing production reports.
    • Perform data studies supporting strategic planning such as plan unit profiling and the impact of proposed benefit changes.
    • Interact with all levels of the organization to gather requirements for reporting requests.
    • Summarize data findings in formalized reports and/or presentations.
    • Maintain an in depth understanding of Fund data sources.
    • Work with The Informatics Department on an ongoing basis to ensure quality claim reporting.
    • Performs other duties as assigned within the scope of responsibilities and requirements of the job.
    • Performs Essential Job Functions and Duties with or without reasonable accommodation.



    • Bachelor's degree in Healthcare Adminstration or related field or equivalent work experience required
    • Preferred Certification in SQL
    • 2 ~ 3 years of direct experience minimum

    • 1 ~ 2 years of SQL query experience preferred. Willingness to attend classes within first six months of employment to improve querying skills

    • 1 ~ 2 years of Javelina experience preferred

    • Working knowledge and experience in performing analytics in a health care environment using medical claims data

    • Working knowledge of common healthcare utilization and cost metrics

    • Working knowledge of common health provider and facility reimbursement methodologies used by payers

    • Working knowledge of medical coding

    • Familiarity with claims adjudication and adjustment methods


    Skills and Abilities:


    • Intermediate level Microsoft Office skills (PowerPoint, Word, Outlook)
    • Intermediate to advanced level Microsoft Excel skills
    • Intermediate level SQL skills preferred
    • Excellent analytical skills and research ability

    • Excellent written and oral communication skills

    • Strong time management and organizational skills

    • Strong interpersonal skills


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