City/State
Norfolk, VA
Work Shift
First (Days)
Overview:
Overview
This position is responsible for general support and functionality within the Sentara Health Plan Encounters Team and the Encounters submission process. This position will operate under the guidance of Sr. Business Analysts and the Encounters Leadership Team to address and satisfy State, Federal, and Internal imperatives.
General Duties / Responsibilities to include, but are not limited to:
- Coordinate with other Encounters Department team members in the preparation, validation, and submission of adjudicated claims data (“Encounters”), to both state and federal agencies.
- Under general supervision, train and develop proficiencies in data analysis techniques relating to Encounters submission data received by the Health Plan from state and federal agencies.
- Work with Sr. Business Analysts to coordinate efforts to identify, analysis, and remediate identified errors via reprocessing,
- Over time, develop sufficient operational expertise (systems and tools, methodologies, contractual / technical requirements) to support the Encounters workstream actively and competently in all major operational areas (data requirements, data structure, submissions, and remediation)
- Establish and maintain working relationships with peers, key departmental stakeholders, and external servicing vendors relating to assigned Market(s) / Lines of Business (LOBs).
- Partner with Sr. Business Analysts and the Encounters Leadership Team in ongoing efforts to establish, maintain, and incorporate improvements to departmental documentation needs (task schedules, submissions tracking, Standard Operation Procedures (SOPs)
- Assist Sr. Business Analysts and the Encounters Leadership Team in ongoing User Acceptance Testing (UAT) needs relating to internal systems upgrades, configuration changes, and new vendor / LOB implementations.
Education
- Bachelor's Degree preferred.
Certification/Licensure
- No specific certification or licensure requirements
Experience
- Three years' of related experience is required in one of the following areas: Operations, IT or Reporting.
Benefits: Caring For Your Family and Your Career
• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to $10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down – $10,000
• Reimbursement for certifications and free access to complete CEUs and professional development
•Pet Insurance
•Legal Resources Plan
•Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission “to improve health every day,” this is a tobacco-free environment.
For positions that are available as remote work, Sentara Health employs associates in the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.