Encounter Data Analyst

Medica's Encounter Data Analyst will be responsible for supporting government encounter data submissions to DHS and CMS. This individual will be working closely with external vendor partners on a day-to-day basis. Perform routine data reconciliations to ensure data submission integrity. Monitor & track encounter metrics to ensure accurate and timely submissions. Review monthly error reports and research critical errors. Collaborate with several internal business units like enrollment & billing, claims operations and provider contracting to identify, escalate and resolve data issues appropriately. Stay informed on DHS and CMS encounter changes, and determine any impact to existing processes. Collaborate with Compliance team on internal compliance audits and State & Federal regulated audits.

Required Qualifications -

• 3+ years of relevant experience
• Bachelor's degree or equivalent experience in healthcare related field
• Understanding of Health Insurance and life cycle of a claim
• Previous experience working in health care/health insurance sector
• Strong communication, documentation, project management skills
• Proficient in at least one data reporting tools
• Proficient in Microsoft Excel, PowerPoint and Word
• Experience with developing detailed documentation of policies and procedures
• Strong interpersonal and communication skills with an ability to work collaboratively with both internal and external stakeholders

Preferred skills or experience -

• Previous claims research experience or knowledge
• Direct Medicaid or Medicare encounters experience
• Helpful to have knowledge of provider contracting and/or provider setup

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)