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 within 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 related 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, Medicaid, and/or ACA revenue cycles for payers
- Intermediate working knowledge of Microsoft Office applications, including but not limited to Word, Excel, Outlook, and PowerPoint
- Conceptual knowledge of SQL, SAS, or MicroStrategy
Company Overview