Careers Specialist

7 days ago


Los Angeles, California, United States MedPOINT Management Full time
MedPOINT Management: Encounter Operations Specialist

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.
Requirements:
  • 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).
Skill and Abilities:
  • 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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