Data Analyst

Data Analyst

  Not Disclosed

  MASON , OH

  6.0 Months

  Not Disclosed

  Not Disclosed

  Services

Job Description

Description/Comment:
Data Analyst– Operations (Network set-up).

GENERAL FUNCTION
Serve as a Data Analyst on the Business Configuration team, responsible for provider agreement, fee schedule and network data integrity initiatives. Provide subject matter expertise for agreement, fee schedule and network setup. Partner with the client cross functional teams to ensure efficiency and accuracy of configuration requests.

MAJOR DUTIES AND RESPONSIBILITIES

Writing SQL queries to extract data from the database, analysis of configuration data to identify clean-up activities.
Ensure agreement configuration accuracy that may impact provider payment and member responsibility.
Set up new Network and Agreement configurations into the Facets system.
Validate agreement and network configuration utilizing claims testing, SQL queries and Excel to ensure the configuration properly adjudicates during claims processing, for member benefit, reimbursements and provider pay amounts.
Perform and resolve network and agreement configuration questions/issues sent to the Business Configuration team without guidance.
Maintain relationships with Account Managers, and Provider teams in order to develop a cohesive cross functional, results driven working environment.
Self-manage completion of work inventory within established quality and turnaround time guidelines.
Coordinate and participate in cross-functional team activities for issue resolution.
Recommend process and system enhancements to drive improvements.
Support the management team with on-going training activities, misc. projects, resolving issues, and serving as a subject matter expert for all Configuration requests.

BASIC QUALIFICATIONS

Associate degree or equivalent experience required.
At least 5 years of experience working within a core claims administration system.
Good analytical and problem-solving skills
A minimum of 2 years’ experience writing SQL queries and exporting data from database tables.
Good communication and interpersonal skills
Ability to work independently or as a part of a team.
Ability to manage multiple complex assignments at once.

PREFERRED QUALIFICATIONS

3+ years’ experience in Operations in the Healthcare industry
Experience understanding claim adjudication for member and provider reimbursements.
Experience with Facets platform using Claims, Provider, Network, Product Benefit Configuration
Knowledge of Medicare and Medicaid programs
SQL and Database experience

Top 3-5 mandatory and/or minimum requirements –

SQL / Healthcare claim understanding, datafeed. / Facets /Analytical & problem solving skill
Top 3-5 desirable attributes/qualifications
5+ years’ experience with Facets platform, Medical Plan Benefit Configuration, Provider Network & Agreement Configuration
SQL and Database experience
Excellent analytical and problem-solving skills, quick learning
Strong communication and interpersonal skills
Bachelor’s degree or equivalent work experience


Note:
Work hours: 8AM to 5PM – 1 hour break (8 hours a day , 40 hours a week).
Onsite two days a week.
Hybrid 2-3 x a week
VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status