| Data Analyst EDI Claims (Healthcare Domain) || Denver, CO (Hybrid). at Denver, Colorado, USA |
| Email: [email protected] |
| Role: Data Analyst EDI Claims (Healthcare Domain) Location: Denver, CO (Hybrid) Duration: 12+ Months Interview: Video Job Description: 8+ years of experience Overall 10+ Years of IT experience. DATA GOVERNANCE, CLAIMS, MEDICAL CLAIMS Minimum 5+ years relevant work experience in: Data Governance, Data Management and Data Quality practices Healthcare payer data products and processes Claims data standards and operations, including, In depth subject matter knowledge of health care claim / encounter terminology, concepts and business processes within one or more data subdomains, e.g., medical, behavioral, vision, dental, pharmacy, etc. Health care data claim / encounter transactions systems, e.g., Proclaim, Facets, EDI Gateway 837, HL7, FHIR, Arcadia or other claim / electronic medical record (EMR) data sources and data repositories Claim / encounter end-to-end lifecycle processes, e.g., submission, processing, payment, reconciliation, etc. Claim / encounter reference data standards, groupers and classifications, e.g., ICD-10, CPT, HCPCS, DRG, APC, ASC, SNOMED CT, EDI implementation guides, etc. Strong communications skills (verbal, listening, written, and presentation) with management teams and peer groups Strong leadership skills to motivate others to achieve goals and inspire change; ability to engage business and data stakeholders to resolve questions or issues; demonstrate ability to create professional relationships and effectively influence cross-functional teams Must have the ability to handle multiple and sometimes competing priorities in a fast-paced environment; ability to organize and develop project plans supporting near and long-range goals and actions; able to strategize across complex, cross-functional projects and initiatives Must have strong analytical and problem-solving capabilities Must be able to think creatively, innovate and flex where needed - quick/adaptive learner and collaborator/team player Self-motivated and able to function with minimal direction Intermediate to Advanced skills in data analysis and data governance tools (e.g., SQL, SAS, TOAD, Python, Hadoop, Teradata, Snowflake, Tableau, Collibra, Infosphere, Alation, etc.) Project management and Six Sigma skills are a plus Experience in Agile Methodology and tools (e.g., Jira, Rally, etc.) Responsibilities Serves as Data Steward dedicated to health care payer Claims data operations & initiatives Works collaboratively with other enterprise and business data stewards to align standards and share best practices; represents Claims data domain in enterprise workgroups and data steward communities of practice Leads Data Governance initiatives and collaborations with business and IT operational stakeholders to: Document, define, maintain, and manage data standards and assets, e.g., Critical Data Elements (CDEs), business terms, definitions, reference data, and business rules Ensure the implementation of the data governance program, tools, best practices and compliance with data standards Assesses and monitors data quality metrics, analyzes trends, and proactively promotes remediation and preventive action efforts In conjunction with the business owners: Defines and communicates metrics to gauge the health and quality of data across enterprise systems Identifies and presents recommendations on business process improvements and efficiencies, including business case and implementation options Provides consultative stewardship services to delivery and issue resolution teams, as needed, to ensure efficient and accurate flow of data. Arun Solanki | Sr.Recruiter | cyberThink | ( 908.988.2600 | * [email protected] | Leader in Staffing and IT Services since 1996 -- Keywords: information technology Colorado Connecticut Data Analyst EDI Claims (Healthcare Domain) || Denver, CO (Hybrid). [email protected] |
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| Wed May 01 21:15:00 UTC 2024 |