Encounters System Analyst

Job Summary

A company is looking for an Encounters System Analyst.

Key Responsibilities

• Manage overall State and Federal Encounters SLAs and KPIs
• Perform hands-on remediation activities to resolve internal and State/CMS rejections
• Collaborate with vendors and engage internal teams to develop solutions based on state documentation

Required Qualifications

• Comprehensive knowledge of healthcare EDI transactions, including 837 and response transactions
• Experience with healthcare program implementations, preferably in Nevada Medicaid
• Proficient in data validation and ensuring quality assurance of submissions
• SQL proficiency for running queries and generating reports
• Familiarity with CMS/state Medicaid programs and EDI standards