Data Analyst – Work From Home

Job Type: Data Analyst from home
Location: California work from home
Company: Abarca Health

Position Description:

As a Medicaid Data Analyst, you will be in charge of, among other things, ensuring that encounter data is correctly managed, transferred, and audited as well as of meeting any necessary contractual obligations. You will assist with the monitoring, submitting, and discussion of encounter data submission business processes and system requirements. You will be able to convert regulatory guidance into appropriate business procedures for our operations and technical team in this capacity. In order to give analysis and identify improvements for our process as we adhere to service level agreements with state regulators and the Centers for Medicaid and Medicare Services, we need your analytical approach and keen eye.

The basics of the position

• Conduct a quality check on the submission files for encounter data.
• Evaluate errors, pinpoint their underlying causes, and take corrective action.
• Directly interact with internal teams to solve problems.
• carries out user acceptance testing and verifies the veracity of the results.
• Utilize analytical software like SQL to study and analyze data.
• Solutions should be explained to both technical and non-technical audiences.
• To ensure Encounter Data accuracy, evaluate technical requirements and regulatory recommendations.
• To ensure that all client and state timeliness criteria are met, implement efficient monitoring programs.
• Participate actively in internal workgroups and work with internal teams to execute clients.
• Determine the significance of Encounter Data by evaluating adjudication, logics, and claims reprocessing.

What you should do is:

• undergraduate degree in a relevant field (In lieu of a degree, equivalent relevant work experience may be considered.).
• 2+ years of experience managing Medicaid claims or managing pharmacy benefits.
• 2+ years of experience dealing with the correctness of Encounter Data and fixing Encounter Data issues directly.
• knowledge of requirements definition and communication.
• knowledge of data submission methods, requirements, and rejections.
• excellent communication skills both in writing and speaking.