Enrollment Support Analyst - 26-34

PriMed Management Consulting•San Ramon, CA

25d•$70,000 - $82,000

About The Position

Under the general direction of the Manager, Enrollment & Operational Quality Services the Enrollment Support Analyst is responsible for analyzing the integrity of departmental data and providing system support for special projects.

Requirements

Minimum of 3-5 years of experience required
Demonstrated proficiency in desktop/PC computer applications and QNXT system
Excellent written- and interpersonal-communication skills
Demonstrate ability to think critically and logically
Independent, dependable, self-starter, detail-oriented team player.
Demonstrated ability to exercise good judgment, prioritize multiple tasks, and problem solve under pressure of deadlines and resource constraints
Strong organizational skills
3 years previous QNXT experience

Responsibilities

Parsing data for loading in QNXT and preparing enrollment edit reports.
Work with the IS Data Center Operations Department ensure timely and accurate loading of health plan generated enrollment files and to ensure health plan data files are in the correct specification for EDI loading of membership files.
Communicate data trends and recurring issues to management.
Using system downloads and reports, perform random integrity check on member eligibility, COB and claims audit data in the QNXT computer system.
Monitor duplicate MRNs and other system discrepancies, distribute correction reports to ES Supervisor for system updates and ensure corrections are made in a timely manner.
Perform routine audits on system data to ensure enrollment is loaded correctly and identify problematic data areas.
Track research outcomes to identify trends and determine if improvement is being made.
Ability to create MS Tables and queries.
Perform spot audits on Enrollment Auditor daily audits.
Attend workgroup meetings and participate in system changes that may affect enrollment data.
Ensure department policy and procedures are updated and presented in a manner that is clearly understood.
Document testing results and work with IS staff on issues that affect enrollment.
Assist Enrollment Auditor with daily membership data audits during periods of heavy workloads and ensure data integrity.
Work with the Information Systems Department to report, explain, and document QNXT issues and test returned CMSRs.
Communicate system and data inconsistencies and audit results to the Department Manager or Supervisor.
Determine and execute the best solution to resolve problems.
Complete special projects as assigned.
Use of multi-media technology to aid in research, to include but not limited to health-plan on-line systems, voice-response systems, Internet, e-mail, phone and fax, and the ability to create MS tables and queries.