Description
The Health Information Management Professional ensures data integrity for claims errors. The Health Information Management Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
Responsibilities
The Health Information Management Professional develops business processes to ensure successful submission and reconciliation of encounter submissions to Medicaid/Medicare. Ensures encounter submissions meet or exceed all compliance standards via analysis of data, and develops tools to enhance the encounter acceptance rate by Medicaid/Medicare. Looks for long term improvements of encounter submission processes. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.
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Required Qualifications
- Bachelor's degree or 3+ years of related worked experience
- 1+ years of Medical claims experience (auditing, processing, loading, etc...)
- Experience with documentation of processes for organizational use
- Experience with analyzing and visualizing large data sets and presenting information to leaders using Excel, PowerPoint and other appropriate software
- Strong analysis, critical thinking, and analytical problem solving skills
- Ability to manage multiple tasks and deadlines with attention to detail
- Excellent written and verbal communication skills
Preferred Qualifications
- Master's Degree in Business Administration or a related field
- 1+ years of X-12 data knowledge
- Working knowledge of SQL writing and creating queries (ORACLE, Microsoft SQL Server, Netezza)
- Prior experience in a fast paced insurance or health care setting
Scheduled Weekly Hours
40