Professional, Data Analyst #881
Full Time- Exempt
Responsible for the creation and accuracy of data extracts and reports, including but not limited to member eligibility, provider, medical & pharmacy encounters, and claim payment. Reconcile data and payment, and ensure complete, accurate and timely revenue within state and federal guidelines. Must constantly monitor the status of new, existing, and previous discrepancies or recovery situations. Actively participate in the development, testing and implementation of file extracts and layouts to meet vendor and regulatory agency requirements. Oversee the extraction, integrity, and submission of data. Analyze Federal and State programs to report trends and recommendations to management. Performs other duties as assigned.
Associate Degree in Health Administration, business, economics, computer science or related field. Related work experience will be considered in lieu of college degree.
Three years of experience in a business environment involving the analysis of financial, member or other large data sets. Experience working with external parties, vendors, or government agencies. Intermediate level experience with writing SQL commands.
• Demonstrated problem-solving and analytical abilities
• Demonstrated ability to work independently with strong attention to detail
• Demonstrated excellent written and verbal communication skills
• Experience with Microsoft Word
• Proven ability to create formulas for financial calculations using Microsoft Excel
• Intermediate data processing skills for use in data warehouse applications, including ability to identify appropriate data fields and write queries to obtain accurate information
• Proven ability to pull, analyze, report, and provide insight on large sets of data
• Extensive reading to stay abreast of the frequent changes in federal and/or state regulations
• Minimal travel required
• Previous Health Insurance experience
• Experience using software automation testing tools
Experience with Lo Code/No Code tools
• Experience in coordination of work with vendors
• Working knowledge of Risk Adjustment
• Working knowledge of ICD-10, CPT, HCPCS and revenue codes.
• Knowledge of Centers for Medicare and Medicaid Services (CMS) and state agency guidelines.
• Knowledge of revenue and data issues relating to CMS/HHS & state agencies
• Experience using data analysis and visualization tools such as Power BI or Tableau
• Understanding of automation tools and automated test capabilities
• Experience with an automated testing tool like Smart Bear, Eggplant, or Selenium
• Ability to write test scripts
• Ability to write test cases & test plans
• Experience working in an agile framework
• Experience with defect tracking software
• Familiar with DevOps related practices
MVP Health Care is a nationally recognized, not-for-profit health insurer caring for more than 700,000 members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal. We are powered by the ideas and energy of more than 1,700 diverse, employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve. MVP Health Care is an Affirmative Action/ Equal Employment Opportunity (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), and the EEO is the Law Poster and Supplement protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at firstname.lastname@example.org
Please apply and learn more – including how you may become a proud member of our team.