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COSMOS Data Analyst

2 months ago

Raleigh, North Carolina, United States Magicforce Full time
About the Role

We are seeking a highly skilled COSMOS Analyst to join our team at Magicforce. As a COSMOS Analyst, you will play a critical role in supporting our business operations by providing expertise in COSMOS/UNET/NICE and healthcare industry standards.

Key Responsibilities
  • Healthcare Industry Knowledge: Possess a deep understanding of US Healthcare Payor workstreams, including Claims Network and Pricing Provider Management, Medical Management, Premium Billing, and Payment, as well as Member Enrollments and Benefits Management.
  • Lines of Business: Have in-depth knowledge of various lines of business, specifically Medicare.
  • Industry Standards and Codes: Be well-versed in healthcare industry standards and codes, including ICD10, HCPCS, CPT, Revenue Codes, DRG, APC, and NDC.
  • COSMOS Configuration: Set up and configure Benefit Plan Network and Supplier Contracts (Pricing) Providers Enrollment Premium and Account subaccounts, etc. Review, interpret, and/or verify contract language information and intent to load information into systems properly. Ensure contract templates can be administered across operations (pricing config claims, etc.).
Requirements
  • Experience: Have experience working with COSMOS/UNET/NICE and healthcare industry standards.
  • Skills: Possess strong analytical and problem-solving skills, with the ability to work in a fast-paced environment.