Sr Systems Analyst - Payer Health Plan (ACA & Medicare) - Remote

Allscripts; Nashville (TN); Remote; USD 60,000 - 100,000; Full time

Job summary

An innovative healthcare solutions firm is seeking a dedicated professional to provide technical support and manage Risk Adjustment data. This role offers remote work flexibility and opportunities for career advancement. You'll engage with enterprise clients, ensuring a high level of customer satisfaction while analyzing claims data and collaborating with development teams. Join a team focused on making a significant impact on healthcare outcomes and enjoy a comprehensive benefits package, including medical and retirement savings. If you're passionate about healthcare technology and eager to grow, this is the perfect opportunity for you.

Benefits

Comprehensive benefits package

Medical insurance

Dental insurance

Vision insurance

Retirement savings plan

Remote work flexibility

Career advancement opportunities

Qualifications

• 5+ years of experience in Risk Adjustment data management.
• Bachelor's degree in a relevant field is required.

Responsibilities

• Provide technical support to enterprise clients regarding product operations.
• Conduct gap analysis and validate data submissions.

Skills

Risk Adjustment Data Management

Claims Data Analysis

Customer Experience

Time Management

Communication Skills

Education

Bachelor’s Degree in Health IT/Informatics/Management Information Systems

Tools

ETL

EDI Standards

Linux

Job description

Employer Industry: Healthcare Technology Solutions

Why consider this job opportunity:
- Remote work flexibility
- Opportunity for career advancement and growth within the organization
- Comprehensive benefits package, including medical, dental, vision insurance, and retirement savings
- Engaging work environment focused on innovative healthcare solutions
- Chance to make a significant impact on healthcare outcomes and client satisfaction

What to Expect (Job Responsibilities):
- Provide technical support to enterprise clients related to operational aspects of the products
- Conduct gap analysis and data validation, identifying issues in data submission
- Analyze and reconcile claims and encounter data, including EDI encounter files
- Collaborate with development teams to resolve support issues and document bugs
- Deliver a consistent and satisfying customer experience with each interaction

What is Required (Qualifications):
- Bachelor’s Degree in Health IT/Informatics/Management Information Systems or related field
- 5+ years of professional experience in Risk Adjustment data management
- Understanding of claims data, encounter response files, and EDI transactions
- Excellent time management and organizational skills
- Strong written and verbal communication skills

How to Stand Out (Preferred Qualifications):
- Familiarity with at least one non-Windows operating system (such as Linux, HPUX, AIX)
- Prior knowledge of CMS submissions process and EDI standards
- Experience with ETL and Mapping
- Knowledge of CMS Risk Score and Risk Adjustment methodologies
- Understanding of Medicaid and its associated processes

#HealthcareTechnology #RemoteWork #CareerGrowth #CustomerSupport #HealthcareSolutions

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