Senior Encounter Data Lead (Hybrid)

Delta Dental of Michigan; Okemos (MI); Hybrid; USD 80,000 - 110,000; Full time

Job summary

Delta Dental of Michigan, Ohio, and Indiana is seeking a Senior Encounter Data Specialist in Okemos, MI. This role leads analysis, correction and recommendations on encounter data issues for internal and external stakeholders, ensuring compliance with processing guidelines.

You will oversee audits, data exchanges (EDI/X12), and cross-functional coordination for onboarding and reporting. The job requires a bachelor’s degree and extensive experience with encounter data, HIPAA, and regulatory

Qualifications

• Bachelor’s degree in business administration or related field and seven years of experience or equivalent.
• Experience with encounter data processing and Medicare/Medicaid regulations preferred.
• Proficiency with EDI formats, databases, analytical reporting tools, and MS Office.
• Strong verbal and written communication with ability to lead cross-functional work.

Responsibilities

• Represents the encounter team to leadership with reports and project updates.
• Leads correction of rejected encounters and ensures compliance with guidelines.
• Monitors and audits encounter submissions for timely, accurate processing.
• Drives onboarding for new customers with cross-functional coordination.
• Acts as SME during audits, coordinating materials and findings.
• Oversees EDI/X12 data exchange compliance and regulatory requirements.
• Maintains encounter policies, error libraries, and reporting tools.
• Maintains data integrity and supports system configurations.
• Leads recruitment and training for encounter data staff.

Skills

Verbal communication

Written communication

Cross-functional leadership

Project coordination

Data analysis

HIPAA compliance knowledge

Ability to manage multiple deadlines

Problem solving

Education

Bachelor’s degree in business administration or related field

Tools

EDI formats

Database applications

Analytical reporting tools

Microsoft Office

Job description

Delta Dental of Michigan, Ohio, and Indiana is seeking a Senior Encounter Data Specialist in Okemos, MI. This role leads analysis, correction and recommendations on encounter data issues for internal and external stakeholders, ensuring compliance with processing guidelines.

You will oversee audits, data exchanges (EDI/X12), and cross-functional coordination for onboarding and reporting. The job requires a bachelor’s degree and extensive experience with encounter data, HIPAA, and regulatory