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RWJBarnabas Health
West Orange, NJ, United States
Req #: 0000130530 Category: Information Systems and IT Status: Full-Time Shift: Day Facility: RWJBarnabas Health Corporate Services Department: Medical Records Location: Remote, 95 Old Short Hills Road, West Orange, NJ 07052 Summary Of Job Function The enterprise master patient index or EMPI is a critical business function and patient safe
Job Source: RWJBarnabas HealtheTeam
Jersey City, NJ, United States
What are we looking for? Ideally the analyst produces logic models which involves working across multiple internal technical platforms and following predefined procedures/standard operating procedures. Steps include gathering and vetting business requirements (speaking with stakeholders to confirm scope), creating data ingests (integrate 3rd party
Job Source: eTeamMetroPlus Health Plan
New York, NY, United States
Director of Encounter Data Reporting Job Ref: 102396 Category: Professional Department: ANALYTICS AND REPORTING Location: 50 Water Street, 7th Floor, New York, NY 10004 Job Type: Regular Employment Type: Full-Time Hire In Rate: $145,000.00 Salary Range: $145,000.00 - $160,000.00 Empower. Unite. Care. MetroPlusHealth is
Job Source: MetroPlus Health PlanNYC Health Hospitals
New York, NY, United States
MetroPlus Health provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a w
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US
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Job Source: USM Business SystemsNew York Life
New York, NY, United States
Location Designation: [[cust_rolelocationdesignation]] When you join New York Life, you’re joining a company that values career development, collaboration, innovation, and inclusiveness. We want employees to feel proud about being part of a company that is committed to doing the right thing. You’ll have the opportunity to grow your career while de
Job Source: New York LifeOpen Systems Technologies
New York, NY, United States
A financial firm is looking for a Technical Business Analyst to join their team in New York, NY. Compensation: $165-170k Responsibilities: Works with key stakeholders and Senior Management to understand and document business needs; Determine project scope and obtain sponsor approval Works with business stakeholders to gather requirements i
Job Source: Open Systems TechnologiesSOL Digital LLC
New York, NY, United States
Who we are SOL DIGITAL is a business consulting firm leading clients through digital transformation, specialized in managing digital project portfolios across Media, Entertainment, Pharmaceutical, Retail and Government. We provide clients business consulting services across Program & Project Management, Business Analysis, Product Management and Sc
Job Source: SOL Digital LLCNewark, NJ, United States
Burlington Office, 62 Merchants Row, Williston, Vermont, United States of America
Headquarters Office, 625 State Street, Schenectady, New York, United States of America
Rochester Office, 20 S. Clinton Ave, Rochester, New York, United States of America
Tarrytown Office, 303 South Broadway, Tarrytown, New York, United States of America
Virtual Req #1914
Tuesday, April 23, 2024
Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full of opportunities to grow. We are a nationally recognized, award-winning leader for a reason. The beating heart of our company is a wide range of employees from a diverse set of backgrounds-tech people, numbers people, even people people-working together to make health insurance better. If you are ready to join a thriving, mission-driven company where you can create your own opportunities and make a positive difference-it's time to make a healthy career move to MVP!
Full-Time, Exempt
Position is remote/virtual
Responsible for state and federal submissions in an accurate and timely manner. Accountable for regulatory reporting within the organization and government entities. Reconciling encounter data and providing root cause analysis of rejections with member eligibility, provider, medical & pharmacy data elements, and claim payment information. Continuously monitor the statuses of existing processes and identify discrepancies or process improvements. Actively participate in the development, testing, and implementation of file extracts and layouts to meet vendor and regulatory agency requirements. Candidates must possess excellent analytical skills with a focus on meeting the expectations and requirements of both internal and external customers. Must be a self-motivated individual and has ability to perform under pressure. Be able to support other duties as assigned.
Position Qualifications
Minimum Education:
Associate Degree in Health Administration, business, economics, computer science or related field.
Related work experience will be considered in lieu of college degree.
Minimum Experience
1+ years of experience in a business environment involving the analysis of healthcare or health insurance data sets. Recent SQL (Intermediate) must have used SQL within the last six months. Able to write and debug queries. Python required. Proven experience of process automation or improvement. Experience working with external parties, vendors, or government agencies.
Required Skills
Microsoft Excel (advanced).
Demonstrated understanding of relational database concepts including ability to manipulate raw data into meaningful, objective information.
Proven ability to pull, analyze, report, and provide insight on large complex sets of data.
Ability to identify areas of process improvement and implement automation efficiencies.
Demonstrated problem-solving and analytical abilities.
Experience working in a routinely audited environment.
Ability to work independently, as well as work effectively as a member of a team.
Demonstrated excellent written and verbal communication skills.
Able to create and update process documentation.
Extensive reading to stay abreast of the frequent changes in federal and/or state regulations.
Preferred Skills
Working knowledge of Risk Adjustment.
Working knowledge of ICD-10, CPT, HCPCS and revenue codes.
Knowledge of Centers for Medicare and Medicaid Services (CMS) and state agency guidelines.
Experience using data analysis and visualization tools.
Experience working in an agile framework.
About MVP
MVP Health Care is a nationally recognized, not-for-profit health insurer caring for members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal. We are powered by the ideas and energy of more than 1,700 diverse employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve.
At MVP, we are committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. Specific employment offers and associated compensation will be made individually based on several factors , including but not limited to geographic location ; relevant experience, education, and training; and the nature of and demand for the role.
In addition, we offer a comprehensive benefits package that includes:
Considerable paid time away from work including PTO (Paid Time Off), s ick t ime, service t ime o ff, p aid h olidays, and f loating h olidays , allowing you to take time off when it suits you best.
Competitive 401(k) employer matching and profit-sharing program to help you save for your retirement.
Low premium health benefits including medical, dental, and vision coverage to support your well-being and that of your family.
Life insurance and disability coverage to ensure financial security for you and your dependents.
An array of optional benefit plans such as accident insurance and specified disease coverage to protect you from the unexpected.
Full tuition reimbursement (up to the IRS limit) for approved courses and programs that support continuous learning.
A best-in-class employee Well-Being program to support all dimensions of your health and wellness.
MVP Health Care analyzes the latest market data to determine employee compensation. Compensation figures listed in a job posting are subject to change as new market data becomes available. The salary range, other compensation, and benefits information is accurate as of the date of this posting. MVP Health Care reserves the right to modify this information at any time, subject to applicable law. More detailed information about total compensation and benefits will be provided during the hiring process.
MVP Health Care is an Affirmative Action/ Equal Employment Opportunity (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), and the Know your Rights protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at [email protected]
Please apply and learn more - including how you may become a proud member of our team.
Other details
Job Family Claims/Operations
Pay Type Salary
Min Hiring Rate $56,200.00
Max Hiring Rate $95,748.00
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Email Alert for Technical Business Analyst, Encounter Data Integrity & Delivery jobs in Newark, NJ, United States
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