Encounters Technical Lead

Job Summary

To support the launch of a Medicare Advantage plan, the full-time Encounters Technical Lead will oversee the technical aspects of encounters data management and analysis, ensuring accurate data processing while collaborating with cross-functional teams in a remote environment.

Key responsibilities

• Oversee end-to-end management of encounters data, including ingestion, cleansing, transformation, and integration
• Provide technical leadership and guidance in encounters data management, setting clear objectives and delivering high-quality solutions
• Implement quality assurance processes and ensure compliance with regulatory requirements related to encounter submissions and response files

Required qualifications

• Bachelor's Degree in Healthcare Administration, Business Administration, Finance, Economics, Information Systems, or a closely related field
• Four years of experience in encounter data management, risk adjustment, or a related field within the healthcare industry
• Strong knowledge of CMS' Encounter Data Processing System (EDPS) data files
• Experience working with claims data to evaluate reimbursement changes and payment discrepancies
• Proficiency in data integration tools and techniques, as well as database management systems