Encounter Data Management Professional

Become a part of our caring community and help us put health first
 The Encounter Data Management Professional develops business processes to ensure successful submission and reconciliation of encounter submissions to Medicaid/Medicare. Ensures encounter submissions meet or exceed all compliance standards via analysis of data, and develops tools to enhance the encounter acceptance rate by Medicaid/Medicare. Looks for long term improvements of encounter submission processes. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.

The Encounter Data Management Professional ensures data integrity for claims errors. The Encounter Data Management Professional work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Use your skills to make an impact
 

Required Qualifications

• Strong analysis, critical thinking, and analytical problem-solving skills
• 2 years or greater of Project Management experience
• Ability to manage multiple tasks and deadlines with attention to detail
• 2 years or greater of process improvement experience
• Excellent communication skills
• Comprehensive knowledge of all Microsoft Office applications, including Word, PowerPoint, Outlook, and advance Excel skills

Preferred Qualifications

• Bachelor's degree or a related field
• Prior health insurance industry experience
• Working knowledge of CAS (Claims Administrative System)
• 2 years of health insurance experience
• Medical claims processing experience

Additional Information

Work-At-Home Requirements

• WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
• A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.  
• Satellite and Wireless Internet service is NOT allowed for this role.
• A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Interview Format

As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate …