Scope of Position
Actively support myMatrixx’s mission and objectives through performing Ad-Hoc analysis and investigations to analyze and implement legislative and regulatory changes, support decision making, and/or reveal new opportunities. This is to be accomplished by means of data analysis in conjunction with acquiring and applying knowledge of the business and systems processes necessary to interpret and produce reliable and valid conclusions from the data.
Essential Job Functions:
- Analyze business functions affected by regulatory and statutory changes
- Work with internal customers and advise on changes needed to systems, including state reporting files, to comply with regulatory and statutory requirements
- Use SQL to identify trends, suggest solutions and solve problems
- Work, document and assist test analysis tickets and issues as needed
- Research medical billing, reporting and fee schedule requirements
- Ensure accuracy of state reporting requirements for workers’ compensation pharmacy and ancillary claims.
- Track development of new legislative and regulatory requirements as it pertains to workers compensation ancillary and pharmacy benefits, mail service pharmacy and pharmacy benefit management requirements and other areas as required
- Write clear, concise summaries of proposed, pending or approved legislation and regulations
Desired Skills and Experience
Experience: Prior workers’ compensation regulatory experience preferred, including pharmacy and ancillary billing and reimbursement requirement analysis and implementation. Strong knowledge of query design and optimization using SQL required. Ability to create and maintain technical design documents
Don’t hesitate to call or email if you have any questions.
Regards,
Theresa Amico
Professional Recruiter, Business Services
Professional Network Group
CareerSource Tampa Bay
9215 N. Florida Ave., Suite 103
Tampa, FL 33612
Tel: 813-930-7685
Fax: 855-503-2977
