Our client is looking for a Sr. Data Analyst to join their Team. The Sr. Data Analyst will be responsible and be a subject matter expert for provider agreement, fee schedule, and network data integrity initiatives.
Responsibilities in this role include:
- Writing SQL queries to extract data from the database, analysis of configuration data to identify clean-up activities.
- Ensure agreement configuration accuracy that may impact provider payment and member responsibility.
- Set up new Network and Agreement configurations into the Facets system.
- Validate agreement and network configuration utilizing claims testing, SQL queries and Excel to ensure the configuration properly adjudicates during claims processing, for member benefit, reimbursements and provider pay amounts.
- Perform and resolve network and agreement configuration questions/issues sent to the Business Configuration team without guidance.
- Maintain relationships with Account Managers, and Provider teams in order to develop a cohesive cross functional, results driven working environment.
- Self-manage completion of work inventory within established quality and turnaround time guidelines.
- Coordinate and participate in cross-functional team activities for issue resolution.
- Recommend process and system enhancements to drive improvements.
- Support the management team with on-going training activities, misc. projects, resolving issues, and serving as a subject matter expert for all Configuration requests.
Top skills you need to have: - SQL/Database experience
- Experience with health provider and network data elements
- 3+ years of experience focused on data analytics
- Analytical & problem solving skills
Preferred skills: - Facets
- Experience with Medicaid and/or Medicare programs and reporting
- Superior communication, critical thinking, teamwork and project management skills
- Experience with Claim adjudication and provider reimbursements
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