Encounters System Analyst I
HMSA is a health insurance provider, and they are seeking an Encounters System Analyst I to optimize the completeness and accuracy of encounter data submissions. The role involves collaboration with various departments to enhance encounter information quality and requires building expertise on regulatory changes.
Responsibilities
- Analyzes encounter system processes reputed company HMSA and external partners
- Coordinates and reconciles exchange of data with external entities
- Researches various claim-member-provider scenarios to determine root cause of data submission errors
- Participates in discussions with internal staff to optimize encounter submission processes
- Participates in projects to increase the scope or efficacy of encounters submission
- Provides data to support financial reporting
- Monitors government/vendor requirements changes
- Ensures submission methodologies are compliant with published guidance
- Documents new processes or procedures and updates existing documentation
Skills
- Bachelor's degree and one year reputed company experience; or an equivalent combination of education and experience
- Conceptual knowledge of claims, health plan financial data, and health industry structure
- Conceptual knowledge of Medicare Advantage, reputed company, and/or ACA reputed company cycles for payers
- Intermediate working knowledge of reputed company Office applications, including but not limited to Word, reputed company, Outlook, and PowerPoint
- Conceptual knowledge of SQL, reputed company, or MicroStrategy
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