Business Analyst - Encounters (Remote)

Sentara Hospitals•Norfolk, VA

11h•Remote

About The Position

This position is responsible for general support and functionality within the Sentara Health Plan Encounters Team and the Encounters submission process. This position will operate under the guidance of Sr. Business Analysts and the Encounters Leadership Team to address and satisfy State, Federal, and Internal imperatives. General Duties / Responsibilities to include, but are not limited to: Coordinate with other Encounters Department team members in the preparation, validation, and submission of adjudicated claims data (“Encounters”), to both state and federal agencies. Under general supervision, train and develop proficiencies in data analysis techniques relating to Encounters submission data received by the Health Plan from state and federal agencies. Work with Sr. Business Analysts to coordinate efforts to identify, analysis, and remediate identified errors via reprocessing, Over time, develop sufficient operational expertise (systems and tools, methodologies, contractual / technical requirements) to support the Encounters workstream actively and competently in all major operational areas (data requirements, data structure, submissions, and remediation) Establish and maintain working relationships with peers, key departmental stakeholders, and external servicing vendors relating to assigned Market(s) / Lines of Business (LOBs). Partner with Sr. Business Analysts and the Encounters Leadership Team in ongoing efforts to establish, maintain, and incorporate improvements to departmental documentation needs (task schedules, submissions tracking, Standard Operation Procedures (SOPs) Assist Sr. Business Analysts and the Encounters Leadership Team in ongoing User Acceptance Testing (UAT) needs relating to internal systems upgrades, configuration changes, and new vendor / LOB implementations.

Requirements

Three years' of related experience is required in one of the following areas: Operations, IT or Reporting.
Strong attention to detail and accuracy in reporting, data validation, and documentation

Nice To Haves

Experience with healthcare data and systems, including Encounter data, 837/834 transactions, EDI, and related reporting
Experience with SQL, Power BI, and Databricks to support analytics, reporting, and data validation
Experience supporting UAT(User acceptance testing), Root Cause Analysis (RCA), and project-based initiatives

Responsibilities

Coordinate with other Encounters Department team members in the preparation, validation, and submission of adjudicated claims data (“Encounters”), to both state and federal agencies.
Under general supervision, train and develop proficiencies in data analysis techniques relating to Encounters submission data received by the Health Plan from state and federal agencies.
Work with Sr. Business Analysts to coordinate efforts to identify, analysis, and remediate identified errors via reprocessing
Over time, develop sufficient operational expertise (systems and tools, methodologies, contractual / technical requirements) to support the Encounters workstream actively and competently in all major operational areas (data requirements, data structure, submissions, and remediation)
Establish and maintain working relationships with peers, key departmental stakeholders, and external servicing vendors relating to assigned Market(s) / Lines of Business (LOBs).
Partner with Sr. Business Analysts and the Encounters Leadership Team in ongoing efforts to establish, maintain, and incorporate improvements to departmental documentation needs (task schedules, submissions tracking, Standard Operation Procedures (SOPs)
Assist Sr. Business Analysts and the Encounters Leadership Team in ongoing User Acceptance Testing (UAT) needs relating to internal systems upgrades, configuration changes, and new vendor / LOB implementations.

Benefits

Medical, Dental, Vision plans
Adoption, Fertility and Surrogacy Reimbursement up to $10,000
Paid Time Off and Sick Leave
Paid Parental & Family Caregiver Leave
Emergency Backup Care
Long-Term, Short-Term Disability, and Critical Illness plans
Life Insurance
401k/403B with Employer Match
Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
Student Debt Pay Down – $10,000
Reimbursement for certifications and free access to complete CEUs and professional development
Pet Insurance
Legal Resources Plan
Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.