Encounter Data Management Professional

Accountabilities

• Analyze encounter data to identify errors, discrepancies, trends, and opportunities for improvement across Medicare and Medicaid submissions.
• Support encounter submission and reconciliation processes, ensuring data meets established quality, compliance, and regulatory requirements.
• Research claims, encounter records, and related data to investigate and resolve processing issues and complex errors.
• Develop and maintain processes or tools that improve encounter acceptance rates, reduce recurring errors, and strengthen data integrity.
• Evaluate encounter submission performance and identify opportunities for sustainable improvements to business processes.
• Communicate analytical findings, identified issues, and potential process impacts to internal business partners and relevant stakeholders.
• Apply established policies, procedures, professional standards, and regulatory guidelines when addressing operational issues.
• Participate in projects, process improvement initiatives, and other programs designed to improve encounter data management.
• Work effectively within established priorities while exercising appropriate judgment when resolving routine issues and escalating matters when necessary.

Requirements

• 2+ years of relevant experience in business processing, data entry, healthcare operations, or a comparable field.
• At least 1 year of experience analyzing, reconciling, or validating data.
• Strong Excel skills, including the ability to maintain and work with complex spreadsheets and perform detailed data analysis.
• Experience working with DOS-based, legacy, or other established business systems.
• Strong attention to detail and the ability to identify inconsistencies, investigate root causes, and maintain data accuracy.
• Analytical and problem-solving skills, with the ability to interpret data and translate findings into practical actions.
• Ability to follow established procedures and regulatory requirements while applying sound judgment to routine operational challenges.
• Clear written and verbal communication skills, with the ability to explain findings and process impacts to business partners.
• Ability to manage priorities, work independently, and consistently meet quality and productivity expectations.
• Preferred: Experience in the health insurance industry, particularly with Medicare or Medicaid.
• Preferred: Working knowledge of Microsoft SQL or SAS and experience working with healthcare claims or encounter data.

Benefits

• Annual salary range of $59,300–$80,900, with actual compensation based on factors such as location, skills, experience, education, and other job-related qualifications.
• Fully remote position available nationwide in the United States.
• Medical, dental, and vision coverage.
• 401(k) retirement savings plan.
• Paid time off, company holidays, and personal holidays.
• Paid parental and caregiver leave.
• Short-term and long-term disability coverage.
• Life insurance.
• Additional benefits and programs supporting employee wellness and healthcare needs.
• 40-hour standard workweek.
• Occasional travel may be required for training or meetings.
• Remote employees must maintain a suitable dedicated workspace and reliable internet connection capable of supporting business requirements and protecting confidential information.