Encounter Data Specialist - Telecommute US
Position Description
Position Summary:
Models and promotes the core values of our Medicaid customers. The Encounter Data Specialist partners with the Encounter Manager, customer, claims operations and provider data management to implement and follow the business requirements for submitting provider claims/encounter data to state Medicaid agencies.
The Encounter Data Specialist understands how information flows across different business processes and systems and uses that information to support encounter reporting according to the State's definitions and rules. The ideal candidate would have had extensive claims processing and analytics experience. This individual will utilize claims, provider and eligibility data knowledge to maintain encounter data quality to exceed 98% acceptance rate.
Principle Duties and Responsibilities: Under the guidance of the Encounter Manager this role will:
Models and promotes the core values of our Medicaid customers. The Encounter Data Specialist partners with the Encounter Manager, customer, claims operations and provider data management to implement and follow the business requirements for submitting provider claims/encounter data to state Medicaid agencies.
The Encounter Data Specialist understands how information flows across different business processes and systems and uses that information to support encounter reporting according to the State's definitions and rules. The ideal candidate would have had extensive claims processing and analytics experience. This individual will utilize claims, provider and eligibility data knowledge to maintain encounter data quality to exceed 98% acceptance rate.
Principle Duties and Responsibilities: Under the guidance of the Encounter Manager this role will:
- Implement, monitor and manage/correct behavioral health encounter data submissions on a weekly basis.
- Produce reports, monitor results as well as report status monthly of encounter statistics.
- Implement corrective action plans to resolve issues impacting state encounter submissions.
- Excellent communication, time/project management, organizational, and analytical skills required.
- Self-driven, proactive problem solver/solution oriented
This position is a Telecommute US opportunity
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