HMSA is a health insurance provider, and they are seeking an Encounters System Analyst I to optimize the completeness and accuracy of encounter data submissions. The role involves collaboration with various departments to enhance encounter information quality and requires building expertise on regulatory changes.
Responsibilities
- 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
Skills
- 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
Company Overview
HMSA is an insurance company that provides affordable health plans, employee benefits services and worksite wellness programs. It was founded in 1938, and is headquartered in Honolulu, Hawaii, USA, with a workforce of 1001-5000 employees. Its website is https://www.hmsa.com.
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