Molina Healthcare Hiring for Encounters Analyst at Las Vegas, Nevada Full Time

Knowledge/Skills/Abilities

The Encounter Analyst is responsible for analyzing complex encounter inbound/outbound process issues, using data from internal and external sources to provide insight to decision-makers.

• Monitors inbound and outbound encounter process. Identifies and interprets encounter data, submission requirements and performance metrics.

• Performs root cause analysis of claims/encounters processing and submission issues; develops recommendations based on data and industry knowledge. Collaborates across departments to design and implement systems changes to meet encounter data processing and submission goals.

• Develops various reports (i.e. exception reports, standard reports and performance reports) and distributes them to appropriate departments for error resolution, follow up and performance monitoring.

• Participates in the workgroup to resolve encounter data and process issues.

• Monitors provider compliance with policies, procedures and regulations for the coding of encounters.

• Develops programs to address provider data and performance gaps.

Required Education

High School Diploma or GED

Required Experience

3-5 Years of Billing, Claims, and Encounter experience

Preferred Education

College Degree or equivalent work experience of 3+ years with claims and/or encounter processing

Preferred Experience

Managed care experience

Preferred License, Certification, Association

Certified Procedural Coder (CPC)

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.