Headquarters Office , 625 State Street, Schenectady, New York, United States of America
Increase your chances of reaching the interview stage by reading the complete job description and applying promptly.
Other Locations :
- Rochester Office, 20 S. Clinton Ave, Rochester, New York, United States of America
- Tarrytown Office, 303 South Broadway, Tarrytown, New York, United States of America
- Virtual Req #1617
Date : Monday, November 20, 2023
Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full of opportunities to grow.
We are a nationally recognized, award-winning leader for a reason. The beating heart of our company is a wide range of employees from a diverse set of backgrounds-tech people, numbers people, even people people-working together to make health insurance better.
If you are ready to join a thriving, mission-driven company where you can create your own opportunities and make a positive difference-it's time to make a healthy career move to MVP!
Position : Full-Time, Exempt
Work Arrangement : Remote / Virtual
Summary
Responsible for the creation and accuracy of data extracts and reports, including but not limited to member eligibility, provider, medical & pharmacy encounters, and claim payment.
Reconcile data and payment, and ensure complete, accurate and timely revenue within state and federal guidelines. Must constantly monitor the status of new, existing, and previous discrepancies or recovery situations.
Actively participate in the development, testing and implementation of file extracts and layouts to meet vendor and regulatory agency requirements.
Oversee the extraction, integrity, and submission of data. Analyze Federal and State programs to report trends and recommendations to management.
Performs other duties as assigned.
Position Qualifications
Minimum Education : Associates Degree in Health Administration, business, economics, computer science or related field. Related work experience will be considered in lieu of college degree.
Minimum Experience : 2 years of experience in a business environment involving the analysis of financial, healthcare, member or other large complex data sets.
Experience working with external parties, vendors, or government agencies.
Required Skills :
- SQL and Microsoft Excel (advanced) required
- Demonstrated understanding of relational database concepts including ability to manipulate raw data into meaningful, objective information
- Proven ability to pull, analyze, report, and provide insight on large complex sets of data
- Ability to identify areas of process improvement and implement automation efficiencies
- Demonstrated problem-solving and analytical abilities
- Experience working in a routinely audited environment
- Ability to work independently, as well as work effectively as a member of a team.
- Demonstrated excellent written and verbal communication skills
- Experience with Microsoft Word and Excel
- Extensive reading to stay abreast of the frequent changes in federal and / or state regulations
Preferred Skills :
- Previous Health Insurance experience
- Python
- Experience in partnering with vendors to accomplish work objectives
- Working knowledge of Risk Adjustment
- Working knowledge of ICD-10, CPT, HCPCS and revenue codes.
- Knowledge of Centers for Medicare and Medicaid Services (CMS) and state agency guidelines.
- Knowledge of revenue and data issues relating to CMS / HHS & state agencies
- Experience using data analysis and visualization tools such as Power BI
- Ability to create testing procedures and policies for updated processes
- Experience working in an agile framework
About MVP
MVP Health Care is a nationally recognized, not-for-profit health insurer caring for members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal.
We are powered by the ideas and energy of more than 1,700 diverse employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve.
At MVP, we are committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting.
Specific employment offers and associated compensation will be made individually based on several factors, including but not limited to geographic location, relevant experience, education, and training, and the nature of and demand for the role.
Benefits
- Considerable paid time away from work including PTO (Paid Time Off), sick time, service time off, paid holidays, and floating holidays, allowing you to take time off when it suits you best.
- Competitive 401(k) employer matching and profit-sharing program to help you save for your retirement.
- Low premium health benefits including medical, dental, and vision coverage to support your well-being and that of your family.
- Life insurance and disability coverage to ensure financial security for you and your dependents.
- An array of optional benefit plans such as accident insurance and specified disease coverage to protect you from the unexpected.
- Full tuition reimbursement (up to the IRS limit) for approved courses and programs that support continuous learning.
- A best-in-class employee Well-Being program to support all dimensions of your health and wellness.
MVP Health Care analyzes the latest market data to determine employee compensation. Compensation figures listed in a job posting are subject to change as new market data becomes available.
The salary range, other compensation, and benefits information is accurate as of the date of this posting. MVP Health Care reserves the right to modify this information at any time, subject to applicable law.
Equal Employment Opportunity
MVP Health Care is an Affirmative Action / Equal Employment Opportunity. We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis.
Any person with a disability needing special accommodations to the application process, please contact Human Resources at [email protected].
Other Details
- Job Family Claims / Operations
- Pay Type Salary
- Min Hiring Rate $44,850.00
- Max Hiring Rate $81,717.00
J-18808-Ljbffr
Professional, Data Analyst
Demonstrated understanding of relational database concepts including ability to manipulate raw data into meaningful, objective information. Responsible for the creation and accuracy of data extracts and reports, including but not limited to member eligibility, provider, medical & pharmacy encoun...
IT Facilities Design Engineer
NTT DATA strives to hire exceptional, innovative and passionate individuals who want to grow with us. We are currently seeking a IT Facilities Design Engineer to join our team in Yonkers, New York (US-NY), United States (US). Understanding of fiber optic test data. Familiar with OSP/ISP engineering ...
Project Manager - Corporate Banking Systems
In this role, the Project Manager will partner with the Business to; develop business requirements, use cases, ROI's, acceptance criteria, manage projects through the SDLC, following the outline established by the Project Management Office, manage budgets, resource plans, change management, all aspe...
Financial Planning Analyst (Tarrytown, NY)
The Financial Analyst - Brand Marketing works closely with brand marketing teams as their right-hand person in a critical role of pricing, planning, financial analysis and reporting for the brands of their responsibility. This person also works closely with R&D, operations, finance, and sales de...
Entry-Level Data Analyst (Remote)
D Aceto Services LLC is seeking a motivated and detail-oriented Entry-Level Data Analyst to join our team. Help maintain data integrity and accuracy within databases. In this remote position, you will work closely with various departments to analyze data, generate insights, and support decision-maki...
Senior Financial Analyst
The Senior Financial Analyst manages the budget and instated cost reports as well as:. Provides technical assistance to departments for budget preparations, and when appropriate, assists in the financial evaluation/assessment of new programs/services. Assist in ensure maximum third party reimburseme...
Business Intelligence Analyst, BIDA
We are seeking a Business Intelligence Analyst to join our Finance team. As a key partner between data and strategy, you will develop scalable solutions that directly impact business growth and operational efficiency. Metric Validation & Data Accuracy: Ensure the accuracy and consistency of financia...
Financial Controls & Reporting Analyst
Work with various stakeholders in bringing items current Assist in preparing mid-year and annual financial reports according to the Governmental accounting standards and other applicable regulatory requirements including preparation of supporting schedules Support collaborating with cross-functional...
Sr. Bioinformatics Data Analyst
The Sr Principal IT Data Analyst (Data Solution Partner) with rich experience building Data Centric Solutions is a key role on the team, enabling science by leading and contributing to full software lifecycle; architecture, design, implementation, testing and deployment of Scientific Data Applicatio...
Senior Construction Project Manager
We have partnered with a Westchester, NY based General Contractor with deep roots in the NY/NJ region who are looking to hire a strong Senior PM with expertise in retail, commercial interiors, and healthcare projects. The company has been in business for several decades and has a strong pipeline wit...