Encounter Data Analyst — Hybrid, Data Quality & Compliance

Delta Dental Plan of Michigan, Inc.; Okemos (MI); Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

401(k) savings plans

Annual incentive compensation

Job summary

Delta Dental of Michigan, Ohio, and Indiana seeks an Encounter Data Specialist to support accurate and compliant encounter data operations. Hybrid position based in Okemos, MI.

You will analyze rejected records, ensure data integrity, and coordinate with multiple internal and external stakeholders to strengthen submission outcomes. The role emphasizes policy development, audits, and reporting, with responsibilities spanning data monitoring, file submissions, and system updates.

Qualifications

• Bachelor's degree in business administration or related field is required.
• Five years of experience identifying, analyzing, or resolving business, system, or process issues in health plan benefits administration is required.
• Knowledge of EDI formats, SQL, database applications, analytical reporting tools, and MS Office is required.
• Strong verbal and written communication skills; ability to manage multiple tasks with deadlines; ability to work independently and collaboratively.

Responsibilities

• Researches, analyzes, corrects, and resubmits rejected encounter records per guidelines and SLAs.
• Reviews and audits encounter data and file submissions for accuracy and compliance.
• Develops and maintains encounter policies, procedures, and error libraries.
• Monitors data integrity and updates related system tables and benefit information.
• Supports new customer implementations and tracks related tasks.
• Assists audits by providing required information and coordinating with departments.
• Reviews EDI/X12 data exchanges to ensure HIPAA compliance and industry standards.
• Identifies error trends and recommends corrective actions and process improvements.
• Prepares recurring metric reports for clients and internal stakeholders.
• Performs other duties as needed to support primary responsibilities.

Skills

Analytical skills

Verbal and written communication

Independent judgment

Multitasking

Team collaboration

Education

Bachelor's degree in business administration or related field

Tools

SQL

EDI formats

Analytical reporting tools

Database applications

Microsoft Office

Job description

Delta Dental of Michigan, Ohio, and Indiana seeks an Encounter Data Specialist to support accurate and compliant encounter data operations. Hybrid position based in Okemos, MI.

You will analyze rejected records, ensure data integrity, and coordinate with multiple internal and external stakeholders to strengthen submission outcomes. The role emphasizes policy development, audits, and reporting, with responsibilities spanning data monitoring, file submissions, and system updates.