Senior Claims & Encounters Analyst

Assist the Claims and Encounters team lead with operational functions related to government programs, requiring deep expertise in regulatory compliance. Cross-functional collaboration is essential to ensure the integrity and efficiency of government program processes. The Senior Analyst will mentor team members and contribute to strategic initiatives. Support operational tasks, including testing, troubleshooting, documentation and Encounter Data submissions. Oversee error handling and change management, ensuring compliance. Conduct root cause analysis and implement corrective actions. Monitor claims processing trends, identifying issues and opportunities. Manage complex claims corrections, Serve as a subject matter expert for Medicare, Medicaid and Exchange operations. Stay current on CMS/State regulatory guidance updates, translating changes into actionable strategies.