Employer Industry: Healthcare Technology Solutions

Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Comprehensive compensation and benefits package, including holidays, vacation, medical, dental, and vision insurance
- Company-paid life insurance and retirement savings options
- Work remotely with flexibility in scheduling
- Supportive and collaborative work environment with a focus on employee development
- Chance to make a significant impact on healthcare outcomes through innovative technology

What to Expect (Job Responsibilities):
- Support encounter data reporting processes and resolve data submission issues
- Conduct gap analysis and data validation to identify potential issues and financial impacts
- Analyze and reconcile claims and encounter data, including 837 EDI encounter files
- Provide technical support to enterprise clients regarding product-related issues
- Collaborate with development and engineering teams to ensure successful product performance

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

How to Stand Out (Preferred Qualifications):
- Familiarity with at least one non-Windows operating system (such as Linux, HPUX, AIX)
- Knowledge of EDI Standards such as X12, EDIFACT, HL7, NCPDP, and HIPAA transactions
- Experience with ETL and Mapping processes
- Knowledge of CMS Risk Score and Risk Adjustment methodologies
- Prior experience with Medicaid systems and processes

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