Careers Specialist
7 days ago
Estimated Salary Range: $55,000 - $70,000 per year.
At MedPOINT Management, we are seeking a skilled Encounter Operations Specialist to join our team. As an Encounter Operations Specialist, you will play a critical role in ensuring the smooth operation of our encounter data extractions and submissions for all assigned clients.
Key Responsibilities:- Daily creation and submission of 837 files for contracted health plans, adhering to industry standards and guidelines.
- Correcting errors generated in the submission process according to SNIP level guidelines while following CMS, DHCS, and health plan regulations.
- Accurately reconciling submitted encounter data.
- Participating in regular meetings with the team leadership and contributing to the review and creation of department standard operation procedures.
- Performing other duties and projects as assigned by management.
- Bachelor's degree preferred; High School Diploma or equivalent required.
- Two years' experience working at a health plan or managed care organization in EDI.
- Proficiency in 837P, 837I, 999, 277, and TA1 transaction files.
- Experience with SNIP validation Levels 1-7.
- Knowledge of Claim adjudication process, CMS1500 and UB04 forms usage, along with ICD-10 diagnosis and procedure codes.
- Proficiency in MS Office suite of products (Excel, Word, PowerPoint, Outlook).
- Multitasking and performing in a fast-paced environment while under minimum supervision.
- Excellent time management skills.
- Excellent verbal, written, communication and organization skills.
- Proactive approach to problem-solving.
- Critical thinking, able to identify trends and patterns.
- Detail-oriented as it relates to compliance and accuracy of data.
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