Encounter Analyst I – Remote
Cognizant Technology Solutions
Reference #: 00061013481
Cognizant is one of the worlds leading professional services companies, we help our clients modernize technology, reinvent processes, and transform experiences, so they can stay ahead in our constantly evolving world. We are looking to expand our team. Do you thrive in a busy environment and able to multi-task successfully? If so, please apply today!
This role is responsible for submission and basic analytics as part of remediation.
Primary Responsibilities:
Creating schedules in client software, monitoring the process to completion for submission of encounter data to the regulatory agency, and processing supplemental chart review files in client software.
Tracking of encounter submission and remediation metrics and creation of submission and remediation metrics and other related reports.
Analyzing metrics deviations (scrubs/rejects) and finding root cause during the remediation process by following desk level procedures including but not limited to researching the client software and client databases.
Analyzing schedule failures if any and working with Prod support/technical teams to resolve it.
Respond to customer queries related to submissions/remediations.
Provide UAT support during product software upgrades, release for new requirements or fixes and validations.
Identifies and interprets encounter data, submission requirements and performance metrics per the regulatory and health plan guidelines.
Responsible for documenting, monitoring, and analyzing the end-to-end encounter life cycle, inbound and outbound encounter process.
Researches and documents all encounter errors in established system(s)/database(s) with appropriate statistical and trend analysis.
Other duties as assigned.
Qualifications:
6 years of related healthcare and/or IT work experience with specific knowledge including claims, membership, provider maintenance, code sets, EDI including 837 and NCPDP file formats, and CMS compliance.
Bachelors degree
Risk adjustment experience is a plus.
Experience with User Acceptance Testing (UAT)
Knowledge of healthcare claims adjudication systems
SQL Server – SSIS and SSRS plus Microsoft cloud technologies will be a plus
Analytical and query writing ability (SQL is a must)
SQL procedure and package – debugging skills
Knowledge on any reporting tools or software (Tableau or Power BI, etc.)
Expertise creating power point presentations.
Excellent written and verbal communication skills
Cognizant will only consider applicants for this position who are legally authorized to work in the United States without requiring company sponsorship now or at any time in the future.
Hourly Rate and Other Compensation:
Applications will be accepted until October 24, 2024
The hourly rate for this position is between $27.64 – $32.00 per hour, depending on experience and other qualifications of the successful candidate. This position is also eligible for Cognizants discretionary annual incentive program, based on performance and subject to the terms of Cognizants applicable plans. Benefits: Cognizant offers the following benefits for this position, subject to applicable eligibility requirements:
Medical/Dental/Vision/Life Insurance
Paid holidays plus Paid Time Off
401(k) plan and contributions
Long-term/Short-term Disability
Paid Parental Leave
Employee Stock Purchase Plan
Disclaimer: The hourly rate, other compensation, and benefits information is accurate as of the date of this posting. Cognizant reserves the right to modify this information at any time, subject to applicable law.
Cognizant is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.