MVP Healthcare
is hiring
Business Analyst, Data Integrity
About Our Company
MVP Health Care is a nationally-recognized, regional not-for-profit health plan committed to having a positive impact on health and wellness of everyone we serve. With MVP, you are assured of quality health care and peace of mind—from a name you know and trust. We care for more than 700,000 members across New York and Vermont, creating healthier communities and continuing our 30-year legacy of quality and integrity.
Job Description & Responsibilities
Responsible for state and federal submissions in an accurate and timely manner. Accountable for regulatory reporting within the organization and government entities. Reconciling encounter data and providing root cause analysis of rejections with member eligibility, provider, medical & pharmacy data elements, and claim payment information. Continuously monitor the statuses of existing processes and identify discrepancies or process improvements. Actively participate in the development, testing, and implementation of file extracts and layouts to meet vendor and regulatory agency requirements. Candidates must possess excellent analytical skills with a focus on meeting the expectations and requirements of both internal and external customers. Must be a self-motivated individual and has ability to perform under pressure. Be able to support other duties as assigned.
Requirements
Minimum Education:
Associate Degree in Health Administration, business, economics, computer science or related field
Related work experience will be considered in lieu of college degree
Minimum Experience
1+ years of experience in a business environment involving the analysis of healthcare or health insurance data sets
Experience working with external parties, vendors, or government agencies
Required Skills
- Recent SQL (Intermediate) must have used within the last six months. Able to write and debug queries.
- Python. Proven experience of process automation or improvement
- Microsoft Excel (advanced)
- 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
- Able to create and update process documentation
- Extensive reading to stay abreast of the frequent changes in federal and/or state regulations
Preferred Skills
- 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
- Experience using data analysis and visualization tools
- Experience working in an agile framework
What we offer
At MVP, we are committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. Specific employment offers and associated compensation will be made individually based on several factors , including but not limited to geographic location ; relevant experience, education, and training; and the nature of and demand for the role.
In addition, we offer a comprehensive benefits package that includes:
- Considerable paid time away from work including PTO (Paid Time Off), sick time, service time off, paid holidays, and floating holidays , allowing you to take time off when it suits you best.
- Competitive 401(k) employer matching and profit-sharing program to help you save for your retirement.
- Low premium health benefits including medical, dental, and vision coverage to support your well-being and that of your family.
- Life insurance and disability coverage to ensure financial security for you and your dependents.
- An array of optional benefit plans such as accident insurance and specified disease coverage to protect you from the unexpected.
- Full tuition reimbursement (up to the IRS limit) for approved courses and programs that support continuous learning.
- A best-in-class employee Well-Being program to support all dimensions of your health and wellness.
MVP Health Care analyzes the latest market data to determine employee compensation. Compensation figures listed in a job posting are subject to change as new market data becomes available. The salary range, other compensation, and benefits information is accurate as of the date of this posting. MVP Health Care reserves the right to modify this information at any time, subject to applicable law. More detailed information about total compensation and benefits will be provided during the hiring process.
