What are the responsibilities and job description for the Encounters System Analyst I position at HMSA?
Employment Type
Full-time
Exempt or Non-Exempt
Exempt
Job Summary
**Hybrid Work Environment - Must reside on Oahu **
Pay Range: $53,000 - $99,000
Note: Individuals typically begin between the minimum to middle of the pay range
Position is responsible for optimizing the completeness and accuracy of encounter data submissions. Role requires collaboration with other departments to maximize quantity and quality of encounter information. Position is responsible for building subject matter expertise on regulatory changes as well as internal documentation of policies and procedures. Position reports on performance internally as needed.
Position also assists with audits, ongoing submissions, and other government finance deliverables.
Minimum Qualifications
Full-time
Exempt or Non-Exempt
Exempt
Job Summary
**Hybrid Work Environment - Must reside on Oahu **
Pay Range: $53,000 - $99,000
Note: Individuals typically begin between the minimum to middle of the pay range
Position is responsible for optimizing the completeness and accuracy of encounter data submissions. Role requires collaboration with other departments to maximize quantity and quality of encounter information. Position is responsible for building subject matter expertise on regulatory changes as well as internal documentation of policies and procedures. Position reports on performance internally as needed.
Position also assists with audits, ongoing submissions, and other government finance deliverables.
Minimum 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.
- 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.
Salary : $53,000 - $99,000