What does a case analyst do?
Case Analysts assess medical information for anesthesia or surgical clearance. They address issues associated with debt law and bankruptcy.They develop, maintain, and support custom applications for the organization. They also perform their duties and responsibilities with minimal supervision, yet they ensure quality all the time.
Case analyst responsibilities
Here are examples of responsibilities from real case analyst resumes:
- Manage a variety of special project task that are request from CMS, and provide by a very strict deadline.
- Assist in the development and implementation of new documentation processes, coordinate workflow and manage credit derivatives documentation backlog.
- Assist investigators (USIS, FIS, DOD, USAF, OPM, FBI, etc . )
- Conduct onsite admission assessments, and concurrent reviews on each member using Milliman criteria.
- Create a 'living' spreadsheet that consolidates key document information and hyperlinks back to the original SharePoint file.
- Calculate reduction for attorney's fees and costs, used diagnosis codes (ICD-9) for relate injuries.
- Report monthly financial statistics for lives, volume, and estimate annual premium according to corporate regulations within Sharepoint.
- Initiate recovery steps in accordance with laws set for each category and in accordance with guidelines establish by CMS.
- Provide medical, billing, and coding analysis (HCPS, CPT and ICD-9) including uniform and customary fee reviews.
- Mentor investigators on investigation techniques and OPM requirements.
- Review complete investigations to ensure DoD interests are safeguard.
- Provide information to agencies regarding OPM investigative policies and procedures.
- Review specification documents to comply with FDA regulations and Pfizer standards.
- Research claims data and applicable guidelines and provide information regarding secondary payer liability for Medicare and Medicaid recipients.
- Research issues regarding payer reimbursement billing, referral credentialing and authorizing communications with outsource representatives such as Medicare and Medicaid.
Case analyst skills and personality traits
We calculated that 15% of Case Analysts are proficient in Management System, Business Procedures, and DOD. They’re also known for soft skills such as Analytical skills, Creativity, and Communication skills.
We break down the percentage of Case Analysts that have these skills listed on their resume here:
- Management System, 15%
Review foreclosure case management reports and make appropriate updates to the automated case management system.
- Business Procedures, 13%
Conduct research, workflow investigations, business procedures and making recommendations.
- DOD, 7%
Reviewed case materials and assembled investigative reports for DoD security clearance requests on a Federal contract.
- SharePoint, 6%
Experience with SharePoint 2010 and 2013 via collaboration tools and the ability to seamlessly integrate with other Microsoft tools.
- Medicaid, 5%
Review Medicaid claims for approval or disapproval Entered data into the system
- Telephone Inquiries, 5%
Answered telephone inquiries and processing correspondence received in relation to the work performed for the Medicare Secondary Payer Recovery Contract.
"management system," "business procedures," and "dod" are among the most common skills that case analysts use at work. You can find even more case analyst responsibilities below, including:
Analytical skills. One of the key soft skills for a case analyst to have is analytical skills. You can see how this relates to what case analysts do because "analysts must interpret complex information from various sources and decide the best way to move forward on a project." Additionally, a case analyst resume shows how case analysts use analytical skills: "assist in training new employees with the input of information into the law enforcement database. "
Creativity. Another essential skill to perform case analyst duties is creativity. Case analysts responsibilities require that "because analysts are tasked with finding innovative solutions to computer problems, an ability to “think outside the box” is important." Case analysts also use creativity in their role according to a real resume snippet: "admitted patients and arrange consultations, reviewed office/medical inventory to order supplies. "
Communication skills. case analysts are also known for communication skills, which are critical to their duties. You can see how this skill relates to case analyst responsibilities, because "analysts work as a go-between with management and the it department and must explain complex issues in a way that both will understand." A case analyst resume example shows how communication skills is used in the workplace: "researched issues regarding payer reimbursement billing, referral credentialing and authorizing communications with outsource representatives such as medicare and medicaid. "
The three companies that hire the most case analysts are:
- CVS Health14 case analysts jobs
- Daily Journal
8 case analysts jobs
- Aetna
7 case analysts jobs
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Compare different case analysts
Case analyst vs. Business analyst/quality analyst
A business analyst/quality analyst is responsible for evaluating business outputs and operational processes to ensure that everything adheres to the quality standards and business regulations. Business analysts/quality analysts support senior management in determining solutions to improve the company's services and provide the highest satisfaction for the customers and clients. They also conduct data and statistical analysis by assessing the market trends to identify opportunities that would generate more revenue resources and increase profitability for the business.
While similarities exist, there are also some differences between case analysts and business analyst/quality analyst. For instance, case analyst responsibilities require skills such as "management system," "business procedures," "dod," and "telephone inquiries." Whereas a business analyst/quality analyst is skilled in "test cases," "qa," "sql server," and "uat." This is part of what separates the two careers.
Business analysts/quality analysts really shine in the finance industry with an average salary of $94,836. Comparatively, case analysts tend to make the most money in the technology industry with an average salary of $54,751.business analysts/quality analysts tend to reach higher levels of education than case analysts. In fact, business analysts/quality analysts are 14.2% more likely to graduate with a Master's Degree and 2.6% less likely to have a Doctoral Degree.Case analyst vs. Information technology analyst
An information technology analyst is responsible for identifying business opportunities by creating and designing technology systems that would help business operations perform efficiently and accurately. Information technology analysts manage systems maintenance, upgrade and install updates for better optimization, and perform feature revisions and adjustments based on the end-user experience. They analyze client and business specifications and research a multiple system approach to generate technology solutions. An information technology analyst must have excellent analytical skills, as well as broad knowledge of the technology industry.
While some skills are similar in these professions, other skills aren't so similar. For example, resumes show us that case analyst responsibilities requires skills like "business procedures," "dod," "medicaid," and "telephone inquiries." But an information technology analyst might use other skills in their typical duties, such as, "infrastructure," "customer service," "security policies," and "switches."
Information technology analysts may earn a higher salary than case analysts, but information technology analysts earn the most pay in the technology industry with an average salary of $94,506. On the other hand, case analysts receive higher pay in the technology industry, where they earn an average salary of $54,751.In general, information technology analysts achieve similar levels of education than case analysts. They're 2.9% more likely to obtain a Master's Degree while being 2.6% less likely to earn a Doctoral Degree.Case analyst vs. Systems analyst programmer
A Systems Analyst Programmer provides technical expertise and recommendations in evaluating new IT software projects. They also indentify solutions and opportunities that can enhance the efficiency of business processes.
Some important key differences between the two careers include a few of the skills necessary to fulfill the responsibilities of each. Some examples from case analyst resumes include skills like "business procedures," "dod," "medicaid," and "telephone inquiries," whereas a systems analyst programmer is more likely to list skills in "c++," "c #," "java," and "database design. "
Systems analyst programmers earn the best pay in the finance industry, where they command an average salary of $94,914. Case analysts earn the highest pay from the technology industry, with an average salary of $54,751.systems analyst programmers typically earn similar educational levels compared to case analysts. Specifically, they're 1.9% more likely to graduate with a Master's Degree, and 2.3% more likely to earn a Doctoral Degree.Case analyst vs. Implementation analyst
An implementation analyst is an individual who is responsible for conducting data analysis and software testing when a company is doing a software upgrade. Implementation analysts must ensure that the company has the appropriate equipment to meet its operational needs by determining which hardware and software they should use. They provide workshops and conduct education for trainers on the functionality of the product as well as to conduct tests to ensure the proper functionality of the product. Implementation analysts must also prepare budgets for proposed equipment or tailor their recommendations to fit an established budget.
Even though a few skill sets overlap between case analysts and implementation analysts, there are some differences that are important to note. For one, a case analyst might have more use for skills like "management system," "business procedures," "dod," and "medicaid." Meanwhile, some responsibilities of implementation analysts require skills like "client facing," "data analysis," "shared services," and "project management. "
Implementation analysts enjoy the best pay in the technology industry, with an average salary of $83,317. For comparison, case analysts earn the highest salary in the technology industry.In general, implementation analysts hold similar degree levels compared to case analysts. Implementation analysts are 2.1% more likely to earn their Master's Degree and 2.6% less likely to graduate with a Doctoral Degree.Types of case analyst
Updated January 8, 2025
