Enterprise Risk Adjustment Analyst - North Hollywood California

Company: VirtualVocations
Location: North Hollywood, California
Posted On: 11/19/2024

A company is looking for an Enterprise Risk Adjustment Analyst to manage data extracts and perform Encounter Data submissions for various healthcare programs.



Key Responsibilities:

Create and manage data extracts for Medicare, Medicaid, and ACA Commercial programs
Review submission reports and reconcile internal data with data submitted to CMS/DHS
Perform root cause analysis to address potential gaps in risk scores


Required Qualifications:

Bachelor's degree in business or related field with 5 years of relevant experience, or 9 years of related work experience in lieu of a degree
Strong knowledge of Claims, Encounters, and Supplemental Data
Expert knowledge of CMS rules and guidance for Risk Adjustment Submissions
Experience with Medicare, Medicaid, and ACA Commercial Data Submissions
Proficiency in extracting data from relational databases and performing data analysis More...

Register an account with us and set up job agents! We'll email you immediately when jobs like this are posted on our site.