What are the responsibilities and job description for the Encounters System Analyst II position at Hawaii Medical Service Association?
- Sustains strong knowledge of encounter system processes within HMSA and external partners.
- Coordinates and reconciles data exchange with external entities, monitoring quality.
- Researches complex claim-member-provider scenarios to determine root cause of data submission errors.
- Coordinates activities with internal staff to optimize encounter submission processes.
- Actively participates in the planning, implementation, and testing of projects to increase the scope or efficacy of encounters submission.
- Analyzes project objectives, data sources, and methodology.
- Provides data to support financial reporting.
- Monitors government/vendor requirements changes. Determines and communicates impact.
- Ensures submission methodologies are compliant with published guidance.
Qualifications:
- Bachelor's degree and three year related experience; or an equivalent combination of education and experience.
- Working knowledge of claims, health plan financial data, and health industry structure.
- Working knowledge of Medicare Advantage, Medicaid, and/or ACA revenue cycles for payers.
- Explains complex information to others in straightforward situations.
- Intermediate working knowledge of Microsoft Office applications, including but not limited to Word, Excel, Outlook, and PowerPoint.
- Conceptual knowledge of SQL, SAS, or MicroStrategy.