Job Summary

A healthcare organization is seeking a Telecommute Senior Provider Data Regulatory Filing Analyst.

Individual must be able to fulfill the following responsibilities:

• Diagnose problems and perform root cause analysis
• Validate state compliance requirements against reports
• Conduct quality inspections of healthcare provider records

Required Skills:

• Strong knowledge of and experience with HCP-HS coding and reimbursement methodologies
• Strong knowledge of healthcare provider contracts, reimbursement terms, and conditions pertaining to the various provider contract types
• Excellent verbal and written communication skills
• Working knowledge of claim processing (PMHS, Proclaim and Facets preferred)
• Knowledge of BI Tools and SQL
• Must be able to work with large excel files