Molina Healthcare
Senior Analyst, Encounters - Remote
United States · Senior
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About the role
- Monitors inbound and outbound encounters submissions and responses, interprets outcomes and takes swift action to remediate errors.
- Understands and communicates financial and performance impacts related to encounter submissions.
- Assists with preparing portions of materials and information for monthly governance and operations reviews.
Responsibilities
- Collaborates across departments to design and implement systems changes to meet encounter data processing and submission goals..
- Develop, execute, and monitor unit testing plans to ensure accurate encounter processing.
- Facilitate coordination between vendors, IT, and business partners to support encounter initiatives
- Performs data analysis using internal and external sources, analyzes processes and provides recommendations for improvement to decision-makers.
- Maintains encounter submission criteria, and maintains submission schedule, central documentation of market nuances, compliance, and regulatory requirements for primary markets or states.
- Maintains market or state specific key performance indicators (KPIs), and reports monthly and quarterly results.
- Performs root-cause analysis of claims and encounter data and develops recommendations based on data and industry knowledge.
- Participates in and/or leads projects to address corrections, changes, and updates to ensure encounter submissions acceptance.
- Develops basic reports and distributes to appropriate departments for error resolution, follow-up, and performance monitoring.
- Strong organizational and time management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines.
Requirements
- Experience with data analysis techniques.
- Ability to work cross-collaboratively across teams/functions.
- Microsoft Office suite and applicable software program(s) proficiency.
Nice to have
- Experience working with various levels of leadership in a highly matrixed organization.
- Certified Professional Coder (CPC).
- To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Compensation
- Molina Healthcare offers a competitive benefits and compensation package.
Benefits
- At least 3 years of experience in billing, claims, encounters, and/or data analysis, preferably in an analyst capacity in a managed care setting, or equivalent combination of relevant education and experience.
This listing is sourced directly from Molina Healthcare's careers page and normalized into a canonical job model.