Employer Industry: Healthcare Technology

Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Comprehensive benefits package including medical, dental, and vision insurance
- Remote work flexibility
- Supportive and collaborative work environment
- Chance to work with cutting-edge artificial intelligence technologies in healthcare

What to Expect (Job Responsibilities):
- Provide technical support to enterprise clients related to operational aspects of the products
- Conduct gap analysis and data validation, identifying issues in data submissions
- Analyze and reconcile claims and encounter data including 837 EDI encounter files
- Collaborate with engineering and development teams to resolve complex technical issues
- Host online troubleshooting sessions and deliver a consistent customer experience

What is Required (Qualifications):
- Bachelor’s Degree in Health IT/Informatics/Management Information Systems or related field
- 5+ years of professional experience in Risk Adjustment data management
- Understanding of claims data, encounter response files, and CMS submissions processes
- Excellent time management and organizational skills
- Strong written and verbal communication skills

How to Stand Out (Preferred Qualifications):
- Familiarity with EDI Standards such as X12, EDIFACT, and HL7
- Knowledge of various network technologies and communication protocols
- Experience with managing product back end and web services
- Prior experience with ETL and Mapping
- Knowledge of Medicaid and CMS Risk Score methodologies

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