Analyst

• Analyzes and investigates customer and transactional data and activity to identify and confirm suspicious activity.
• Files SARs & CTRs with regulatory agencies for activity that has been escalated by internal teams, external partners and third parties including Law Enforcement.
• Maintains service levels with workload in accordance to policies, procedures and compliance standards.
• Answers inbound and outbound calls to provide servicing for monitoring strategies and customer inquiries.
• Maintains standards of Production, Quality and Leadership results for workstreams assigned.
• Other duties as assigned.

FIU Cases Analyst I

• Manage day-to-day application operations for assigned departments
• Provide expertise in area of application responsibility
• Optimize the application through development of new functionality
• Communicate all necessary application changes to all affected departments

Epic Application Analyst II – HIM

• Completes scheduled and urgent benefit additions, terminations, and changes timely and accurately to prevent member access to care issues, missed performance guarantees and potential liquidated damages.
• Acquires and maintains a basic level of knowledge and interpretation of multiple adjudication system screens and functions on a field-by-field level to design both standard and custom configurations to meet client expectations.
• Complies with standards set forth regarding benefit design and configuration including HIPAA, NCPDP and Navitus internal business standards.
• Performs quality assurance peer reviews and uses sound business judgment and expertise to contribute toward the creation of root cause analysis of issues.
• Uses departmental workflow management, issue resolution and reporting tools for troubleshooting and responding to general customer questions and issue resolution requests.
• Supports internal customers by participating in client meetings, audits and new program implementations with other areas of the company, answering benefit setup questions and providing guidance to other areas and roles on the benefit configuration process.
• Adapts to industry changes and evolving technology, maintaining a basic level of understanding of both legacy and emerging products and systems.
• Independently assesses business needs and participates in process improvement, cost reduction and automation efforts.
• Contributes to the creation and ongoing maintenance of departmental training materials, work instructions and policies.
• Conducts system enhancement and regression testing of a low to moderate level of complexity for benefit configuration processes to ensure compliance with state, federal and client regulations/standards.
• Contributes to training and maintains a mentoring relationship with new and existing benefit configuration team members.
• Participate in, adhere to and support compliance and diversity, equity, and inclusion program objectives.

Benefit Configuration Analyst

• Participate in global banking structure evaluations and implementations, supporting relationship management, fee benchmarking, and service reviews
• Assist with bank account rationalization, openings, closings, and signer maintenance
• Administer global online banking platforms, user entitlements, and periodic access reviews
• Maintain robust controls and documentation over banking permissions and approval workflows
• Monitor global daily cash positions and execute international funding transfers to meet operating needs
• Manage and monitor inter-company settlements and related reconciliations
• Partner with Accounting and FP&A on short- and long-term cash forecasts, including variance analysis, and identify opportunities to optimize working capital and shorten the cash conversion cycle
• Support debt reporting, repayments, covenant compliance, and forecasting of repayment schedules and interest costs
• Help identify and measure FX exposures across global entities. Support execution, settlement, and documentation of hedging activities
• Support corporate insurance renewals, manage claims and respond to insurance related inquiries
• Work with the accounting team to ensure the general ledger is updated timely with proper accounting for investments, derivatives, and foreign currency revaluation
• Assist in building and maintaining treasury dashboards and reporting packages for management
• Maintain treasury policies and SOX documentation; respond to internal/external audit requests and assist in SOX reviews
• Ensure compliance with internal controls, treasury policies, and regulatory requirements
• Identify and implement automation across reporting, reconciliation, and forecasting workflows
• Partner with IT and Treasury leadership on TMS implementation, treasury systems and banking platform enhancements
• Collaborate with internal stakeholders, including Accounting, Finance and Tax, to align Treasury activities with broader financial objectives

Senior Treasury Analyst

• Configure and customize financial systems such as ERP/General Ledger, Financial Reporting, Travel, and Reimbursement, to align with business and regulatory requirements, processes, and changes. Develop and maintain custom fields, forms, workflows, and records to enhance system functionality.
• Act as a subject matter expert to departments and leaders across ActBlue on the configuration, customization, data, and reporting functionality within our ERP system.
• Provide ERP support to users within the organization by troubleshooting issues, resolving problems, and offering guidance on system usage. Conduct training sessions for new and existing users to ensure optimal utilization of NetSuite features.
• Continually build out automation of manual processes, as well as NetSuite General Ledger and NetSuite Planning and Budgeting (NSPB) reporting.
• Support new integrations and system implementations related to ERP.
• Monitor interfaces with the payment processing (Stripe), travel platform (Navan), payroll system (Rippling), expense management (Expensify), corporate cards (American Express), corporate transportation (UBER/Lyft) and Amalgamated Bank. Ensure the integrity of interfaces and troubleshoot to resolve any issues.
• Ensure all updates and transitions to new releases are implemented without interruption to the production environment.
• Communicate effectively with internal and external stakeholders to provide updates, gather feedback, and address concerns.
• Support supplementary projects as assigned, ensuring timely and efficient completion in line with organizational objectives and standards.

Senior ERP Analyst, NetSuite

• Responsible for the coordination, documentation, communication and analysis of provider productivity, compensation and benefits
• Performs quantitative and qualitative analysis of healthcare and financial data to support program management within the physician and advanced practice provider compensation department
• Summarize provider revenues and work relative value units (WRVUs)
• Gather data for payroll processing and benefit day tracking
• Assist in the overall preparation and design of monthly compensation process, budget, and survey and market analysis through data gathering, entry and validation
• Maintains financial records and documentation

Physician Compensation Analyst

• Collaborates with relationship managers in gathering and evaluating commercial credit related information on current and prospective customers by preparing written reports of analysis which include in-depth analysis of financial statements, historical and projection-based cash flow and ratio analysis, suggested credit structure, general industry analysis and identified risks.
• Reads, reviews, and understands various financial statements to include but not limited to; tax returns, balance sheets, profit and loss statements, agings, borrowing base certificates, debt schedules, equipment lists, credit bureau reports, rent rolls, lease agreements, and appraisals.
• Prepares financial spreads for various types of commercial and real estate businesses, municipalities, non-profits, and individuals acting as direct obligation borrowers or guarantors.
• Analyzes credit worthiness of commercial applicants and guarantors as appropriate by reviewing the loan application, spreading historical and projection based financial statements, calculating cash flows, leverage, and liquidity ratios, evaluating collateral, conducting research on the borrower(s) and key industries, and identifying risks.
• Analyzes findings and authors a comprehensive report of analysis using a mix of data analysis (charts, formulas, graphs, etc.) and written narrative.
• Evaluates credit quality and suggests proper risk rating based on analysis of most recent financial information.
• Ensures compliance to applicable regulations and keeps up-to-date with changes in federal regulations and FIB credit policy requirements.

Credit Analyst II

• Completes scheduled and urgent benefit additions, terminations, and changes timely and accurately to prevent member access to care issues, missed performance guarantees and potential liquidated damages.
• Acquires and maintains a basic level of knowledge and interpretation of multiple adjudication system screens and functions on a field-by-field level to design both standard and custom configurations to meet client expectations.
• Complies with standards set forth regarding benefit design and configuration including HIPAA, NCPDP and Navitus internal business standards.
• Performs quality assurance peer reviews and uses sound business judgment and expertise to contribute toward the creation of root cause analysis of issues.
• Uses departmental workflow management, issue resolution and reporting tools for troubleshooting and responding to general customer questions and issue resolution requests.
• Supports internal customers by participating in client meetings, audits and new program implementations with other areas of the company, answering benefit setup questions and providing guidance to other areas and roles on the benefit configuration process.
• Adapts to industry changes and evolving technology, maintaining a basic level of understanding of both legacy and emerging products and systems.
• Independently assesses business needs and participates in process improvement, cost reduction and automation efforts.
• Contributes to the creation and ongoing maintenance of departmental training materials, work instructions and policies.
• Conducts system enhancement and regression testing of a low to moderate level of complexity for benefit configuration processes to ensure compliance with state, federal and client regulations/standards.
• Contributes to training and maintains a mentoring relationship with new and existing benefit configuration team members.
• Participate in, adhere to and support compliance and diversity, equity, and inclusion program objectives.
• Other duties as assigned.

Analyst, Benefit Configuration

• Leads system requirements analysis and validation activities using established industry methodologies, ensuring requirements are complete, consistent, traceable, feasible, and conform to standards.
• Builds and maintains deep knowledge of the business processes, capabilities, and services supported by the platform and applies that expertise to guide requirements definition, solution design and prioritization, collaborating with product stakeholders and revenue partners.
• Establishes, documents, implements, and continuously improves processes for system planning, requirements definition, and release planning.
• Partners with customers, project managers, and revenue stakeholders to understand needs and present solutions that align with business and technical objectives.
• Defines system and solution approaches based on experience, sound judgment, and creative problem solving.
• Provides system development effort and cost estimates in support of ROI analysis and resource planning.
• Produces and maintains initiative system documentation and platform system documentation.
• Works with engineering teams to develop user stories, use cases, and delivery plans.
• Creates and maintains technical documentation for use by engineering and operations teams.
• Continuously expands understanding of business processes, platform capabilities, and supported services to improve solution quality, decision-making and stakeholder outcomes.
• Troubleshoots and resolves issues in existing systems to improve reliability and performance.
• Provides work breakdowns, schedules, and coordination for assigned initiatives.
• Other duties as assigned.

Platform Analyst – Advisor

• Leads system requirements analysis and validation activities using established industry methodologies, ensuring requirements are complete, consistent, traceable, feasible, and conform to standards.
• Builds and maintains deep knowledge of the business processes, capabilities, and services supported by the platform and applies that expertise to guide requirements definition, solution design and prioritization, collaborating with product stakeholders and revenue partners
• Establishes, documents, implements, and continuously improves processes for system planning, requirements definition, and release planning.
• Partners with customers, project managers, and revenue stakeholders to understand needs and present solutions that align with business and technical objectives.
• Defines system and solution approaches based on experience, sound judgment, and creative problem solving.
• Provides system development effort and cost estimates in support of ROI analysis and resource planning.
• Produces and maintains initiative system documentation and platform system documentation.
• Works with engineering teams to develop user stories, use cases, and delivery plans.
• Creates and maintains technical documentation for use by engineering and operations teams.
• Continuously expands understanding of business processes, platform capabilities, and supported services to improve solution quality, decision-making and stakeholder outcomes.
• Troubleshoots and resolves issues in existing systems to improve reliability and performance.
• Provides work breakdowns, schedules, and coordination for assigned initiatives.
• Other duties as assigned.

Platform Analyst – Advisor/Manager

Senior Platform Analyst

• Provide clinical leadership and subject-matter expertise to support the analysis, configuration, and administration of complex medical policy content within claims processing systems, including Plan General Exclusion (PGE) rules and FACETS table maintenance.
• Ensure the accurate implementation of medical policies, review criteria, and authorization requirements, while maintaining the integrity of system infrastructure and serving as a key liaison between business and technical teams.
• Research and analyze system and business issues, develop high-level requirements, test and implement solutions, and audit and document outcomes.
• Mentor and train Coding Specialists, and provide policy-related training and support to operational partners such as customer and provider services.

Health Services Coding Analyst, CPC Required

• Conduct thorough research and investigation of participant accounts to identify potential fraud or suspicious activity
• Analyze large datasets and spreadsheets, including reviewing IP addresses, transaction histories, and account behaviors, to detect patterns or irregularities
• Identify and escalate findings where information appears inconsistent, out of place, or indicative of fraudulent behavior
• Prepare and issue legal notices and correspondence to clients and participants related to fraud investigations
• Maintain strict confidentiality when handling sensitive personal and financial information
• Perform daily report reviews to monitor system-generated alerts, flagged accounts and ongoing account activity
• Ensure all investigations and documentation are completed accurately and in compliance with internal policies and regulations
• Meet strict deadlines for case resolution, reporting, and compliance requirements
• Maintain detailed, organized documentation of case findings and actions taken
• Collaborate cross-functionally with compliance, legal, service, and operations, and executive leaders as needed
• Continuously monitor trends and patterns to proactively identify emerging fraud risks
• Assist teammates with escalations, appeals, Salesforce cases and tasks as needed
• Other duties as assigned

Analyst jobs in South Dakota

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FIU Cases Analyst I

Epic Application Analyst II – HIM

Benefit Configuration Analyst

Senior Treasury Analyst

Senior ERP Analyst, NetSuite

Physician Compensation Analyst

Credit Analyst II

Analyst, Benefit Configuration

Platform Analyst – Advisor

Platform Analyst – Advisor/Manager

Senior Platform Analyst

Senior Platform Analyst

Health Services Coding Analyst, CPC Required

Fraud Analyst