MRA Encounter Analyst

P3 Health Partners • Henderson, NV

1d

About The Position

At P3 Health Partners, the company's promise is to guide communities to better health, unburden clinicians, align incentives, and engage patients. It is a physician-led organization focused on transforming healthcare from sickness care into wellness guidance. The primary role of the Risk Adjustment Encounter Analyst (RAA) is to function as the encounter SME for P3. The RAA implements data analytic reports, analyzes and researches data errors and issues related to CMS submissions, collaborating with internal departments for resolution and risk outcome improvement. The RAA will own the encounter adjustment workflow for regulatory retrospective chart review efforts and monitor/manage end-to-end data flow of submissions to vendors and government agencies to mitigate data leakage, including identifying root cause and mitigation efforts. The RAA will review and apply all related regulatory requirements to department activities. The position is also responsible for ad-hoc projects, data oversight, and analyses, requiring problem-solving skills and the ability to prioritize deadlines.

Requirements

• Basic to intermediate skill level with Microsoft Excel, SQL & Power Point
• Ability to problem solve
• Strong claims processing skill
• Understanding of medical terminology
• Familiarity with medical records
• Basic Data Warehouse knowledge and experience with Microsoft SQL
• Strong communication and strong written skills
• BA or BS – Mathematics, Finance, Economics, Management, other

Nice To Haves

• Working knowledge of the provider-based healthcare industry
• Working knowledge of claims processing
• Working knowledge of provider billing
• Working knowledge of Risk Adjustment
• Working knowledge of Medicare Advantage

Responsibilities

• Analyze, prioritize & support resolution of Claims/ Encounter data errors by triaging to the appropriate internal departments for a resolution, and/or work with encounter submissions vendor for resolution
• Work with the Director and Market Risk Adjustment Analysts on monthly operational and performance reporting and dashboards
• Monitor and manage end-to-end data submissions to vendors and government agencies for assigned populations to mitigate data leakage and/or submission errors.
• Cross-train to handle similar tasks across all lines of business

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 101-250 employees