Enrollment Support Analyst - 26-34

PriMed Management Consulting Services, Inc.
Stockton, United States of America
7 days ago

Role details

Contract type
Permanent contract
Employment type
Full-time (> 32 hours)
Working hours
Regular working hours
Languages
English
Experience level
Intermediate
Compensation
$ 82K

Job location

Stockton, United States of America

Tech stack

Microsoft Excel
Software Applications
Information Systems
Data Centers
Data Files
Data Integrity
Data Retrieval
Epic ECSA
Data Inconsistencies

Job description

Under the general direction of the Manager, Enrollment & Operational Quality Services the Enrollment Support Analyst is responsible for analyzing the integrity of departmental data and providing system support for special projects., * Parsing data for loading in EPIC and preparing enrollment edit reports.

  • Work with the IS Data Center Operations Department ensure timely and accurate loading of health plan generated enrollment files and to ensure health plan data files are in the correct specification for EDI loading of membership files.
  • Communicate data trends and recurring issues to management.
  • Using system downloads and reports, perform random integrity check on member eligibility, COB and claims audit data in the EPIC system.
  • Monitor duplicate MRNs and other system discrepancies, distribute correction reports to ES Supervisor for system updates and ensure corrections are made in a timely manner.
  • Perform routine audits on system data to ensure enrollment is loaded correctly and identify problematic data areas.
  • Track research outcomes to identify trends and determine if improvement is being made.
  • Ability to create MS Tables and queries.
  • Ability to navigate EXCEL and Access Data Base.
  • Perform spot audits on Enrollment Auditor daily audits.
  • Attend workgroup meetings and participate in system changes that may affect enrollment data.

Additional Responsibilities:

  • Ensure department policy and procedures are updated and presented in a manner that is clearly understood.
  • Document testing results and work with IS staff on issues that affect enrollment.
  • Assist Enrollment Auditor with daily membership data audits during periods of heavy workloads and ensure data integrity.
  • Work with the Information Systems Department to report, explain, and document EPIC issues.
  • Communicate system and data inconsistencies and audit results to the Department Manager or Supervisor.
  • Determine and execute the best solution to resolve problems.
  • Complete special projects as assigned.
  • Use of multi-media technology to aid in research, to include but not limited to health-plan on-line systems, voice-response systems, Internet, e-mail, phone and fax, and the ability to create MS tables and queries.

Requirements

  • Minimum of 3-5 years of experience required
  • Demonstrated proficiency in desktop/PC computer applications and EPIC system
  • Excellent written- and interpersonal-communication skills
  • Demonstrate ability to think critically and logically
  • Independent, dependable, self-starter, detail-oriented team player.
  • Demonstrated ability to exercise good judgment, prioritize multiple tasks, and problem solve under pressure of deadlines and resource constraints
  • Strong organizational skills
  • 3 years previous EPIC experience

Required Education:

  • High School Diploma/GED

About the company

At Hill Physicians Medical Group, we're shaping the healthcare of the future: actively managed care that prevents disease, supports those with chronic conditions and anticipates the needs of our members. Join Our Team! Hill Physicians has much to offer prospective employees. We're regularly recognized as one of the "Best Places to Work in the Bay Area" and have been recognized as one of the "Healthiest Places to Work in the Bay Area." When you join our team, you're making a great choice for your professional career and your personal satisfaction. DE&I Statement: At PriMed, your uniqueness is valued, celebrated, encouraged, supported, and embraced. Whatever your relationship with Hill Physicians, we welcome ALL that you are. We value and respect your race, ethnicity, gender identity, sexual orientation, age, religion, disabilities, experiences, perspectives, and other attributes. Our celebration of diversity and foundation of inclusion allows us to leverage our differences and capitalize on our similarities to better serve our communities. We do it because it's right!

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