Encounter Data Submissions Program Manager

Employer Industry: Healthcare Technology

• Opportunity for career advancement and growth within the organization
• Flexible work schedules with the ability to work remotely
• Comprehensive health, dental, and vision insurance paid up to 80% for employees and dependents
• Robust time-off plan including 21 days of PTO in your first year and 11 paid holidays
• 12 weeks paid parental leave for all new parents and six weeks paid sabbatical after six years of service
• 401(k) with up to 4% match and stock options

• Assist in the development of programming documentation and standard operating procedures (SOPs)
• Oversee daily encounter data submissions and reconciliation processes
• Identify and establish Alternate Submission Method (ASM) processes with additional eligible payers
• Collaborate with senior leadership and legal partners to ensure compliance with regulatory requirements
• Conduct annual ROI evaluation of ASM processes, including the submission of dropped diagnoses

• Bachelor's degree in Business, Finance, Information Technology, Analytics, Operations, or a related field
• 4+ years of experience with Medicare Advantage or ACA encounter data processes and/or risk adjustment experience
• 1+ years of knowledge in X-12 837 data
• Strong analytical skills with the ability to interpret complex data sets
• Proficiency in using common business software such as Microsoft Office Suite and project management tools

• Excellent communication and presentation skills, both written and verbal
• Familiarity with Business Process Reengineering (BPR) principles and methodologies
• Medicare claims experience
• Fundamental understanding of relational databases

#Healthcare Technology #Remote Work #Career Growth #Employee Benefits #Healthcare Innovation

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