Professional, Sr. Analyst, Data Delivery #826
The role is a critical part of this transformation, acting as a technical resource to automate existing processes and reports to improve efficiency as well as overall quality. This role is responsible for the accuracy of Government Programs and ACA Commercial data including but not limited to member eligibility, provider, medical & pharmacy encounters, and payment. Reconcile data and payment, ensure complete, accurate and timely revenue within CMS/HHS and New York State 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, data integrity and data submission. Analyze Government Programs and ACA Commercial data to identify report trends and recommendations to management. Performs other duties as assigned.
Associate Degree in Health Administration, Business, Economics, Computer Science, or related field. Bachelor degree preferred.
3 years experience as a Data Analyst in health insurance encounter data submission. Experience using Microsoft Power Platform tools preferred. Experience using software automation tools.
Experience writing SQL commands.
- Demonstrated problem-solving and analytical abilities.
- Ability to process and query data for use in data warehouse applications.
- Demonstrated ability to work independently with strong attention to detail.
- Excellent written and verbal communication skills.
- Strong Microsoft Excel skills, ability to create financial calculation formulas.
- Experience working with large datasets/big data.
- Experience working with Federal and/or State encounter data submission regulation changes.
- Working knowledge of Risk Adjustment.
- Working knowledge of ICD-9, 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 working with third party vendors.
- Previous Health Insurance experience.
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.