Ensure accurate and compliant Medicare and Medicaid encounter submissions.
Use data analysis and process improvement techniques to increase submission acceptance rates and operational efficiency.
Work independently on routine to moderately complex issues and support departmental goals through process improvement.
Support encounter data integrity by managing claims and encounter data errors.
Identify issues, recommend solutions, and ensure compliance with Medicaid data submission requirements.
Manage and analyze large datasets related to Medicaid claims and encounter data to identify trends and patterns.
Maintain data quality control processes to ensure accuracy and completeness of data.
Collaborate with teams to design and implement data management solutions.
Conduct data validation and quality assurance activities to ensure data integrity.
Develop and maintain documentation of data management processes.

1+ year of experience in medical claims adjudication, claims auditing, or encounter submissions.
Ability to accurately resolve claims issues and meet established deadlines.
1+ year of experience conducting root cause analysis and implementing resolutions.
1+ year of experience documenting processes, procedures, and findings accurately and thoroughly.
Bachelor's degree in business, Finance, Accounting, Operations or other related fields (preferred).
Experience identifying, researching, and resolving Medicaid claims and encounter data errors (preferred).
Prior health insurance industry experience (preferred).
Working knowledge of Microsoft SQL or SAS (preferred).

medical, dental and vision benefits
401(k) retirement savings plan
time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
short-term and long-term disability
life insurance

Encounter Data Management, Medicaid Research Professional

Key skills