Hybrid Encounter Data Specialist — Data Quality & Compliance

Delta Dental of Michigan; Okemos (MI); Hybrid; USD 60,000 - 80,000; Full time

Job summary

Delta Dental of Michigan, Ohio, and Indiana is hiring an Encounter Data Specialist in Okemos, MI, offering a hybrid work model. The role focuses on analyzing and correcting encounter data, ensuring compliance, and collaborating with stakeholders to improve data quality and processing accuracy.

The position requires a bachelor’s degree in a related field and at least five years of experience dealing with health plan data issues, with preferred Medicare/Medicaid regulatory knowledge.

Qualifications

• Bachelor's degree in business administration or related field required.
• Five years of experience identifying, analyzing, or resolving business, system, or process issues in health plan benefits.
• Experience with Medicare and/or Medicaid programs and related regulations preferred.
• Knowledge of word processing, spreadsheet, presentation, and database applications; strong verbal and written communication skills; strong analytical skills.

Responsibilities

• Analyzes, corrects, and recommends solutions to encounter data issues, policies, processes, and records.
• Corrects rejected encounters in compliance with processing guidelines and best practices.
• Researches, reviews, and interprets encounter data to identify issues and address rejected records.
• Monitors, manages, and audits encounter submissions to ensure timely and accurate file submission and processing.
• Develops, maintains, and updates encounter policies and procedures.
• Maintains data integrity across system configurations and collaborates with stakeholders to resolve issues.

Skills

Word processing

Spreadsheets

Presentations

Databases

Verbal and written communication

Analytical skills

Independence / self-management

Multitasking

Education

Bachelor's degree in business administration or related field

Job description

Delta Dental of Michigan, Ohio, and Indiana is hiring an Encounter Data Specialist in Okemos, MI, offering a hybrid work model. The role focuses on analyzing and correcting encounter data, ensuring compliance, and collaborating with stakeholders to improve data quality and processing accuracy.

The position requires a bachelor’s degree in a related field and at least five years of experience dealing with health plan data issues, with preferred Medicare/Medicaid regulatory knowledge.