This position is responsible for ensuring the integrity of the claims/encounter data so that it is current, complete, and processed accurately through the systems of the company as well as provides analysis to increase operational efficiency. The Encounter Data Specialist works under the supervision of the Director of Finance to provide specialized services that ensure the flow through process of encounters from the provider user community, revenue cycle management, data clearinghouse and strategic partners.
This position works independently as well as collaborating closely with various departments of the MemorialCare System. This is a position that needs to integrate process improvement plans with the current processes as the healthcare industry evolves and coordinate with project managers and IT developers to ensure each improvement plan is accomplished in the timely manner.
Minimum of two (2) years of managed care health plan encounter data experience.
Strong understanding of health care code sets including CPT, HCPCs, ICD-10 and revenue codes.
Strong skills in MS office; including intermediate to advanced MS Excel and MS Access skills a plus.
Strong analytical, organization and interpersonal skills.
Knowledge of claims, payment and pricing, provider contracts, membership and enrollment a plus.
Knowledge of Trans Union application and MHC / QNXT application preferred.
Excellent verbal, written and presentation skills.
High school graduate or equivalent required.
AA, or BA/BS degree preferred.
Internal Number: SEA000103
Let us introduce ourselves. We're MemorialCare, a nonprofit health system that includes four hospitals, two medical groups, imaging centers, surgical centers and much more. As one of the leading health systems in Orange County and Los Angeles County, we're confident that no matter what your needs are, we have the teams, tools and know-how to support you every step of the way.