What are the responsibilities and job description for the Encounters System Analyst I position at Hawaii Medical Service Association?
- Analyzes encounter system processes within HMSA and external partners.
- Coordinates and reconciles exchange of data with external entities.
- Researches various claim-member-provider scenarios to determine root cause of data submission errors.
- Participates in discussions with internal staff to optimize encounter submission processes.
- Participates in projects to increase the scope or efficacy of encounters submission.
- Provides data to support financial reporting.
- Monitors government/vendor requirements changes.
- Ensures submission methodologies are compliant with published guidance.
- Documents new processes or procedures and updates existing documentation.
Qualifications:
- Bachelor's degree and one year related experience; or an equivalent combination of education and experience.
- Conceptual knowledge of claims, health plan financial data, and health industry structure.
- Conceptual knowledge of Medicare Advantage, Medicaid, and/or ACA revenue cycles for payers.
- Intermediate working knowledge of Microsoft Office applications, including but not limited to Word, Excel, Outlook, and PowerPoint.
- Conceptual knowledge of SQL, SAS, or MicroStrategy.