Remote Encounter Data Analyst - Data Quality & Compliance

Network Health; Menasha (WI); Remote; USD 70,000 - 90,000; Full time

Job summary

Network Health in Wisconsin seeks an experienced Encounter Data Analyst to support Medicaid encounter data functions for the Medicaid TPA line. You will identify and correct data errors, coordinate with vendors and internal teams, and ensure compliance with DHS laws and standards.

The role requires a Bachelor's degree in IT or health care information, 3+ years in health insurance or government programs, 2+ years as a Business Analyst, Medicaid experience, and strong data analysis and SQL skills.

Qualifications

• Bachelor’s degree in IT or health care information or equivalent experience.
• 3+ years in health insurance or government programs.
• 2+ years as a Business Analyst or similar role.
• Experience with Medicaid, DHS file submissions (837/834).
• Ability to analyze data to identify trends and improve processes.
• SQL skills and MS Office proficiency.

Responsibilities

• Lead encounter data error identification and coordinate resolutions with external vendors, clients and internal departments.
• Act as liaison between vendors, clients and internal teams.
• Coordinate maintenance and enhancements for the Medicaid Encounter Tracking System (METS).
• Develop workflows and documentation for encounter data processes.
• Stay informed on DHS regulations and how they affect submissions.
• Attend DHS technical calls and propose automation to improve processes.

Skills

Data analysis

SQL proficiency

Microsoft Office

Education

Bachelor's Degree in Information Technology/Health Care Information or equivalent

Tools

SQL

MS Office

Job description

Network Health in Wisconsin seeks an experienced Encounter Data Analyst to support Medicaid encounter data functions for the Medicaid TPA line. You will identify and correct data errors, coordinate with vendors and internal teams, and ensure compliance with DHS laws and standards.

The role requires a Bachelor's degree in IT or health care information, 3+ years in health insurance or government programs, 2+ years as a Business Analyst, Medicaid experience, and strong data analysis and SQL skills.