Headquarters Office, 625 State Street, Schenectady, New York, United States of America
Rochester Office, 220 Alexander Street, Rochester, New York, United States of America Req #1110
Thursday, April 14, 2022
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
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. Proactively identify process improvements and workflow automation opportunities.
POSITION QUALIFICATIONS
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:
Three years of experience in a business environment involving the analysis of financial, member or other large data sets. Experience working with external parties, vendors, or government agencies.
Required Skills:
Demonstrated problem-solving and analytical abilities
Demonstrated ability to work independently with strong attention to detail
Demonstrated excellent written and verbal communication skills
Experience with Microsoft Office 365 suite of applications.
Intermediate data processing skills for use in data warehouse applications, including ability to identify appropriate data fields and write queries to obtain accurate information
Intermediate level experience with writing SQL commands
Proven ability to pull, analyze, report, and provide insight on large sets of data
Minimal travel required
Preferred Skills:
Experience with Python or similar coding language
Experience using data analysis and visualization tools such as Power BI or Tableau
Understanding of automation tools and automated test capabilities
Experience with an automated testing tools (ex Eggplant, Selenium)
Ability to write test scripts
Ability to write test cases & test plans
Experience working in an agile framework
Experience with defect tracking software
Familiar with DevOps related practices
Previous Health Insurance experience
Experience using software automation testing tools
Experience in coordination of work with vendors
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
About MVP 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 EEO is the Law Poster and Supplement 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 hr@mvphealthcare.com
Please apply and learn more - including how you may become a proud member of our team.
Other details
Job Family Information Technology & Transformation Services
Pay Type Salary
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Headquarters Office, 625 State Street, Schenectady, New York, United States of America
Rochester Office, 220 Alexander Street, Rochester, New York, United States of America