Eligibility & Encounters Data Analyst (Accountable Care) - Remote

Overview

The Eligibility and Enrollment Data Analyst plays a crucial role in maintaining eligibility data integrity for ACO members, collaborating with various stakeholders to ensure accurate processing of encounter data and effective communication.

In Short

• Verify eligibility using Health Plan websites and contacts.
• Create/update member records and coverage in Tapestry.
• Coordinate with third-party vendors for data processing.
• Assist in the creation and maintenance of procedure documents.
• Manage communication with internal customers and external vendors.
• Respond to email traffic and phone calls in a timely manner.
• Re-prioritize work to adapt to departmental changes.
• Meet productivity and quality standards set by management.
• Participate in special projects as assigned.
• Adhere to safety, HIPAA, and compliance policies.

Requirements

• Associate degree or equivalent experience.
• 3-5 years of related experience in a health-related field.
• Knowledge of Electronic Data Interchange processes.
• Experience with claims and referrals preferred.
• Proficiency in Microsoft Office Suite.
• Strong verbal/written communication skills.
• Ability to maintain composure in challenging interactions.
• Organizational skills to prioritize tasks effectively.
• Skill in identifying and resolving problems.
• Ability to interpret and apply guidelines and procedures.

Benefits

• Opportunity to work in a leading healthcare organization.
• Engagement in meaningful work that impacts patient care.
• Collaborative work environment with diverse teams.
• Professional development opportunities.
• Commitment to equal opportunity and diversity.