Encounter Data Analyst
About The Position
Trillium Health Resources is a Tailored Plan and Managed Care Organization (MCO) serving 46 counties across North Carolina. We manage services for individuals with serious mental health needs, substance use disorders, traumatic brain injuries, and intellectual/development (IDD) disabilities. Our mission is to help individuals and families build strong foundations for healthy, fulfilling lives. Trillium Health Resources has a career opening for an Encounter Data Analyst to join our team! The Encounter Data Analyst is responsible for reviewing and monitoring adjudicated claims for encounter file submission and upstream processing and communicating with provider agencies and internal departments regarding encounter submission and denial management. This position will also monitor encounters submitted by our Tailored Plan subcontractors ensuring all contract service level agreements are met.
Requirements
- High School Diploma or GED and two (2) years in processing medical information or data management and reporting; OR
- Equivalent combination of education/experience.
- Must have a valid driver’s license.
- Must reside within North Carolina.
- Must be able to travel within catchment as required.
Nice To Haves
- Associate’s degree in Information Technology, Statistics, Data Analytics, Business, or a Human Services field (such as Psychology, Social Work, etc.).
- Experience in the areas of data analysis, data management, statistics, reporting, and use of databases.
Responsibilities
- Track adjudicated claims from received date to upstream encounter submission and verify response received from the Department.
- Review data flow between claim system and encounter file submissions; identify and report any discrepancies.
- Maintain documentation of failed/denied encounters and the communications associated with the follow-up performed to address the issues with internal staff and external provider agencies.
- Ensure Service Level Agreements (SLA) are met.
- Monitor Tailored Plan subcontractors claims and ensure all are submitted as encounters.
Benefits
- Typical working hours: 8:30 am – 5:00 pm; flexible work schedules with some roles with management approval.
- Work-from-home options available for most positions
- Health Insurance with no premium for employee coverage
- Flexible Spending Accounts
- 24 days of Paid Time Off (PTO) plus 12 paid holidays in your first year
- NC Local Government Retirement Pension (defined-benefit plan)
- 401k with 5% employer match and immediate vesting
- Public Service Loan Forgiveness (PSLF) qualifying employer
- Quarterly stipend for remote work supplies
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
501-1,000 employees
