data analyst Williston, VT
Job description
Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full of opportunities to grow. We are a nationally recognized, award-winning leader for a reason. The beating heart of our company is a wide range of employees from a diverse set of backgrounds—tech people, numbers people, even people people—working together to make health insurance better. If you are ready to join a thriving, mission-driven company where you can create your own opportunities and make a positive difference—it’s time to make a healthy career move to MVP!
Full-Time, Exempt
Position will be Remote/Virtual
Summary:
Responsible for the creation and accuracy of data extracts and reports, including but not limited to member eligibility, provider, medical & pharmacy encounters, and claim payment. Reconcile data and payment, and ensure complete, accurate and timely revenue within state and federal guidelines. Must constantly monitor the status of new, existing, and previous discrepancies or recovery situations. Actively participate in the development, testing and implementation of file extracts and layouts to meet vendor and regulatory agency requirements. Oversee the extraction, integrity, and submission of data. Analyze Federal and State programs to report trends and recommendations to management. Performs other duties as assigned.
POSITION QUALIFICATIONS
Minimum Education:
Associates Degree in Health Administration, business, economics, computer science or related field. Related work experience will be considered in lieu of college degree.
Minimum Experience:
2 years of experience in a business environment involving the analysis of financial, healthcare, member or other large complex data sets. Experience working with external parties, vendors, or government agencies.
Required Skills:
- SQL and Microsoft Excel (advanced) required
- Demonstrated understanding of relational database concepts including ability to manipulate raw data into meaningful, objective information
- Proven ability to pull, analyze, report, and provide insight on large complex sets of data
- Ability to identify areas of process improvement and implement automation efficiencies
- Demonstrated problem-solving and analytical abilities
- Experience working in a routinely audited environment
- Ability to work independently, as well as work effectively as a member of a team.
- Demonstrated excellent written and verbal communication skills
- Experience with Microsoft Word and Excel
- Extensive reading to stay abreast of the frequent changes in federal and/or state regulations
- Previous Health Insurance experience
- Python
- Experience in partnering with vendors to accomplish work objectives
- Working knowledge of Risk Adjustment
- Working knowledge of ICD-10, CPT, HCPCS and revenue codes.
- Knowledge of Centers for Medicare and Medicaid Services (CMS) and state agency guidelines.
- Knowledge of revenue and data issues relating to CMS/HHS & state agencies
- Experience using data analysis and visualization tools such as Power BI
- Ability to create testing procedures and policies for updated processes
- Experience working in an agile framework
MVP Health Care is a nationally recognized, not-for-profit health insurer caring for more than 700,000 members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal. We are powered by the ideas and energy of more than 1,700 diverse, employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve. MVP Health Care is an Affirmative Action/ Equal Employment Opportunity (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), and the Know your Rights protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at [email protected]
Please apply and learn more – including how you may become a proud member of our team.
