Reinsurance Analyst

Blue Cross Blue Shield of Arizona

. Assist with day-to-day activities for the reinsurance department .

Posted 10/5/2026full-timeRemote • Arizona • United StatesJuniorMid-LevelWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in health plan reinsurance processes, including claims management and compliance with AHCCCS guidelines. Proficient in analytical research, reporting, and maintaining effective working relationships within a healthcare environment.

Highest-signal resume keywords

Health Plan Reinsurance ExperienceAHCCCS Administration KnowledgeClaims Processing UnderstandingAnalytical Research AbilitiesKnowledge of Medicaid and Medicare Regulations

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Reinsurance RecoveryClaims ManagementFinancial ReportingCOB VerificationExcelWordBeginner SQLMedMcQNXTOracle

Soft Skills

Effective CommunicationRelationship BuildingMotivational Support

Tools & Technologies

PMMISData Warehouse

Industry Keywords

AHCCCS GuidelinesReinsurance RequirementsHealthcare System DesignAccounts PayableStop-Loss Reimbursement

Tech Stack

Tools & technologies

OracleSQL

About the role

Key responsibilities & impact

Assist with day-to-day activities for the reinsurance department
Research and review claims to recover eligible stop-loss reimbursement
Identify and manage Transplant Reinsurance claims and cases
Coordinate with Medical Services’ transplant coordinator to create and maintain transplant cases and stages with AHCCCS
Review transplant logs and monitor case stages and component payments
Enter and maintain transplant reinsurance cases in PMMIS
Track and balance encounters against PMMIS screen RI113 before component submission
Identify and manage Catastrophic Reinsurance claims and cases
Submit annual Catastrophic Reinsurance renewal letters to AHCCCS Medical Management within 30 days of each contract year
Coordinate with the Claims department to ensure proper processing of Medicaid reinsurance claims
Ensure reinsurance claims and CRNs are encountered and associated according to applicable rates
Adhere to timely filing limits
Review AHCCCS reinsurance reports monthly
Work with Accounting and Data Warehouse to maintain accurate reinsurance reconciliation
Maintain current knowledge of AHCCCS reinsurance manuals, procedures, and requirements
Review high-dollar claims reports to ensure all reinsurance is captured
Provide motivation, encouragement, instruction, and role-model support to others or subordinates depending on level
Perform other duties as assigned

Requirements

What you’ll need

2 years of experience in health plan reinsurance, claims unit, or AHCCCS administration (Level 1)
3 years of experience in health plan reinsurance, claims unit, or AHCCCS administration (Level 2)
High School Diploma or GED
Knowledge of healthcare and system design, including Oracle
Knowledge of accounts payable and financial reporting
Analytical research and reporting abilities
Knowledge of reinsurance recovery, recoupments, refund posting, and COB verification
Knowledge of Medicaid and Medicare coverage and regulations
Understanding of claims processing
Knowledge of AHCCCS guidelines and reinsurance requirements
General knowledge of Excel, Word, Beginner SQL, MedMc, and QNXT
Ability to communicate effectively orally and in writing
Ability to establish and maintain effective working relationships
Ability to perform duties of lower levels for progressive levels
Must work a full-time schedule of at least 40 hours per week
Bachelor’s degree in accounting, business, or related field is preferred

Benefits

Comp & perks

Remote work within the state of Arizona
Full-time employment (at least 40 hours per week)
Flexible work location under AZ Blue’s Workability workforce strategy
Health insurance products and services offered by the employer