Encounter Validation Senior ConsultantPrimary Location: Phoenix, AZ
Additional Locations: AZ-Phoenix Apply
- Prepare, validate, submit, load, and log 837 encounter files and 277, 824, 999, NCPDP response files in accurate and timely manner according to state and federal regulations
- Analyzes complex data for trends, highlights in-depth interpretations and provides in-depth root cause analysis
- Performs ongoing research, and support tasks for existing systems
- Creates complex queries, does technical report/programming
- Translates complex data into constructive data and information and makes recommendations
- Illustrates complex information in a clear concise manner
- Influences changes/enhancements to business processes, policies, and system infrastructure to improve information quality, availability and access
- Evaluates available software and data to deliver better business solutions
- Influences enhancements to business processes to improve data quality availability and access
- Manages Health Plan and State contact, participates in internal and external health industry development efforts (e.g., performance measurements)
- Provides workgroup support on projects
- May lead or act as a business technical expert with the planning, development and validation of master or detail test plans and strategies
- Leads or acts as a business technical expert in the design of new applications or enhancements including integration of solutions
- Provides Leadership/Coaching/Mentoring; may be a mentor to others
- Directs the implementation of program specific information through education, technology, organizational methods and procedures.
- 837, 277, 999 encounter file preparation and correction experience
- Extensive experience with databases as well interpretation and manipulation of related data
- Strong organizational skills. Knowledge of all types of managed care products
- Working knowledge of Microsoft Office products (Word, Excel, PowerPoint, Outlook) and Internet Explorer.
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