Remote Medicaid Encounter Data Lead

Network Health; Menasha (WI); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Network Health in Wisconsin seeks an Encounter Data Analyst to support Medicaid encounter data functions and ensure compliance with DHS regulations. You will identify data errors, coordinate corrections with vendors and internal teams, and help maintain the METS tool.

This role requires experience with Medicaid, DHS submissions (837/834), and data-driven process improvements. The position emphasizes collaboration with claims, enrollment, IT, and other departments, plus attendance at DHS calls

Qualifications

• 3+ years in a health insurance or government programs role
• 2+ years as a Business Analyst or similar role
• Prior Medicaid experience with DHS file submissions (837/834)
• Experience using data to identify trends, solve problems and improve processes
• Ability to analyze data to determine error sources and trends
• Intermediate/advanced Microsoft Office skills; SQL preferred

Responsibilities

• Lead the encounter data error identification effort and coordinate error resolutions with external vendors and clients as well as internal departments
• Act as a liaison between external vendors, clients and internal departments
• Coordinate the maintenance and enhancements for the Medicaid Encounter Tracking System (METS) tool
• Develop workflows and other documentation related to encounter data processes
• Remain informed and updated on industry changes e.g. DHS regulations and changes and how they impact encounter data submissions
• Attend all DHS technical calls
• Propose innovative approaches to create or improve automation and optimize processes

Skills

Data analysis

Problem solving

Communication

Attention to detail

Querying

Education

Bachelor's Degree in Information Technology or Health Care Information

Tools

SQL

Microsoft Office

Reporting tools

Job description

Network Health in Wisconsin seeks an Encounter Data Analyst to support Medicaid encounter data functions and ensure compliance with DHS regulations. You will identify data errors, coordinate corrections with vendors and internal teams, and help maintain the METS tool.

This role requires experience with Medicaid, DHS submissions (837/834), and data-driven process improvements. The position emphasizes collaboration with claims, enrollment, IT, and other departments, plus attendance at DHS calls