What are the responsibilities and job description for the Senior Encounters System Analyst position at HMSA?
Employment Type
Full-time
Exempt or Non-Exempt
Exempt
Job Summary
**Hybrid Work Environment - Must reside on Oahu **
Pay Range: $68,000 to $133,000
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 for multiple lines of business. Role leads collaboration with other departments to develop solutions that maximize the quantity and quality of encounter information. Position is responsible for sustaining subject matter expertise on regulatory changes as well as internal documentation of policies and procedures. Position reports on performance internally and externally as needed.
Position assumes a leadership role for 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: $68,000 to $133,000
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 for multiple lines of business. Role leads collaboration with other departments to develop solutions that maximize the quantity and quality of encounter information. Position is responsible for sustaining subject matter expertise on regulatory changes as well as internal documentation of policies and procedures. Position reports on performance internally and externally as needed.
Position assumes a leadership role for audits, ongoing submissions, and other government finance deliverables.
Minimum Qualifications
- Bachelor's degree and four years of 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.
- Intermediate working knowledge of Microsoft Office applications, including but not limited to Word, Excel, Outlook, and PowerPoint.
- Conceptual knowledge of SQL, SAS, or MicroStrategy.
- Sustains mastery of encounter system processes within HMSA and external partners, for multiple lines of business.
- Monitors trends in data exchange with external entities and recommends adjustments as needed.
- Researches highly nuanced claim-member-provider scenarios to determine root cause of data submission errors.
- Leads collaboration with internal staff to optimize encounter submission processes.
- Leads the planning, design, implementation, and testing of projects to increase the scope or efficacy of encounters submission.
- Prioritizes project deliverables to ensure business needs are met.
- Serves as a resource for colleagues with less experience.
- Provides data to support financial reporting.
- Monitors government/vendor requirements changes. Determines and communicates impact, recommends adjustments as needed.
Salary : $68,000 - $133,000