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Technical Business Analyst, Encounter Data Integrity & Delivery
Schenectady, NY
Job Description
Technical Business Analyst, Encounter Data Integrity & Delivery
Burlington Office, 62 Merchants Row, Williston, Vermont, United States of America * Headquarters Office, 625 State Street, Schenectady, New York, United States of America * Rochester Office, 20 S. Clinton Ave, Rochester, New York, United States of America * Tarrytown Office, 303 South Broadway, Tarrytown, New York, United States of America * Virtual Req #1914
Tuesday, April 23, 2024
Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full of opportunities to grow. We are a nationally recognized, award-winning leader for a reason. The beating heart of our company is a wide range of employees from a diverse set of backgrounds-tech people, numbers people, even people people-working together to make health insurance better. If you are ready to join a thriving, mission-driven company where you can create your own opportunities and make a positive difference-it's time to make a healthy career move to MVP!
Full-Time, Exempt
Position is remote/virtual
Responsible for state and federal submissions in an accurate and timely manner. Accountable for regulatory reporting within the organization and government entities. Reconciling encounter data and providing root cause analysis of rejections with member eligibility, provider, medical & pharmacy data elements, and claim payment information. Continuously monitor the statuses of existing processes and identify discrepancies or process improvements. Actively participate in the development, testing, and implementation of file extracts and layouts to meet vendor and regulatory agency requirements. Candidates must possess excellent analytical skills with a focus on meeting the expectations and requirements of both internal and external customers. Must be a self-motivated individual and has ability to perform under pressure. Be able to support other duties as assigned.
POSITION QUALIFICATIONS
Minimum Education:
Associate Degree in Health Administration, business, economics, computer science or related field.
Related work experience will be considered in lieu of college degree.
Minimum Experience:
1+ years of experience in a business environment involving the analysis of healthcare or health insurance data sets. Recent SQL (Intermediate) must have used SQL within the last six months. Able to write and debug queries. Python required. Proven experience of process automation or improvement. Experience working with external parties, vendors, or government agencies.
Required Skills:
Preferred Skills:
About MVP
MVP Health Care is a nationally recognized, not-for-profit health insurer caring for 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.
At MVP, we are committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. Specific employment offers and associated compensation will be made individually based on several factors , including but not limited to geographic location ; relevant experience, education, and training; and the nature of and demand for the role.
In addition, we offer a comprehensive benefits package that includes:
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 Know your Rights 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 hr@mvphealthcare.com
Please apply and learn more - including how you may become a proud member of our team.
Other details
Burlington Office, 62 Merchants Row, Williston, Vermont, United States of America * Headquarters Office, 625 State Street, Schenectady, New York, United States of America * Rochester Office, 20 S. Clinton Ave, Rochester, New York, United States of America * Tarrytown Office, 303 South Broadway, Tarrytown, New York, United States of America * Virtual Req #1914
Tuesday, April 23, 2024
Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full of opportunities to grow. We are a nationally recognized, award-winning leader for a reason. The beating heart of our company is a wide range of employees from a diverse set of backgrounds-tech people, numbers people, even people people-working together to make health insurance better. If you are ready to join a thriving, mission-driven company where you can create your own opportunities and make a positive difference-it's time to make a healthy career move to MVP!
Full-Time, Exempt
Position is remote/virtual
Responsible for state and federal submissions in an accurate and timely manner. Accountable for regulatory reporting within the organization and government entities. Reconciling encounter data and providing root cause analysis of rejections with member eligibility, provider, medical & pharmacy data elements, and claim payment information. Continuously monitor the statuses of existing processes and identify discrepancies or process improvements. Actively participate in the development, testing, and implementation of file extracts and layouts to meet vendor and regulatory agency requirements. Candidates must possess excellent analytical skills with a focus on meeting the expectations and requirements of both internal and external customers. Must be a self-motivated individual and has ability to perform under pressure. Be able to support other duties as assigned.
POSITION QUALIFICATIONS
Minimum Education:
Associate Degree in Health Administration, business, economics, computer science or related field.
Related work experience will be considered in lieu of college degree.
Minimum Experience:
1+ years of experience in a business environment involving the analysis of healthcare or health insurance data sets. Recent SQL (Intermediate) must have used SQL within the last six months. Able to write and debug queries. Python required. Proven experience of process automation or improvement. Experience working with external parties, vendors, or government agencies.
Required Skills:
- Microsoft Excel (advanced).
- Demonstrated understanding of relational database concepts including ability to manipulate raw data into meaningful, objective information.
- Proven ability to pull, analyze, report, and provide insight on large complex sets of data.
- Ability to identify areas of process improvement and implement automation efficiencies.
- Demonstrated problem-solving and analytical abilities.
- Experience working in a routinely audited environment.
- Ability to work independently, as well as work effectively as a member of a team.
- Demonstrated excellent written and verbal communication skills.
- Able to create and update process documentation.
- Extensive reading to stay abreast of the frequent changes in federal and/or state regulations.
Preferred Skills:
- 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.
- Experience using data analysis and visualization tools.
- Experience working in an agile framework.
About MVP
MVP Health Care is a nationally recognized, not-for-profit health insurer caring for 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.
At MVP, we are committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. Specific employment offers and associated compensation will be made individually based on several factors , including but not limited to geographic location ; relevant experience, education, and training; and the nature of and demand for the role.
In addition, we offer a comprehensive benefits package that includes:
- Considerable paid time away from work including PTO (Paid Time Off), s ick t ime, service t ime o ff, p aid h olidays, and f loating h olidays , allowing you to take time off when it suits you best.
- Competitive 401(k) employer matching and profit-sharing program to help you save for your retirement.
- Low premium health benefits including medical, dental, and vision coverage to support your well-being and that of your family.
- Life insurance and disability coverage to ensure financial security for you and your dependents.
- An array of optional benefit plans such as accident insurance and specified disease coverage to protect you from the unexpected.
- Full tuition reimbursement (up to the IRS limit) for approved courses and programs that support continuous learning.
- A best-in-class employee Well-Being program to support all dimensions of your health and wellness.
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 Know your Rights 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 hr@mvphealthcare.com
Please apply and learn more - including how you may become a proud member of our team.
Other details
- Job Family Claims/Operations
- Pay Type Salary
- Min Hiring Rate $56,200.00
- Max Hiring Rate $95,748.00
Job Summary
Company
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Education
Associate Degree
Required Experience
1+ years
Security Clearance Note
Claims/Operations
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