• Generate comprehensive and concise in-depth reporting and analysis for Pre-Pay and Post-Paid Processes • Provide Provider Pre Pay production and progress reports and coordinate with management and team • Recommend process or procedure changes and build strong relationships with cross departmental teams • Demonstrate leadership ability, including mentoring Program Integrity Claims Analysts • Identify knowledge gaps and provide training opportunities • Research, comprehend and interpret various state specific Medicaid, federal Medicare, and ACA/Exchange laws • Responsible for making claim payments decisions on a variety of claims • Respond to claim questions and concerns and prepare claims for Medical Director review