Responsible for the timely and accurate submission of claim encounters to Medicaid and Medicare for claims processed on behalf of members enrolled in various Centers Plan for Healthy Living (CPHL) products. Collaborates with vendors to ensure the complete and accurate generation of encounter files. Interacts with various departments within the organization to maintain current on the federal and state requirements for encounter processing.
Education and Experience:
Required: Bachelor’s degree in Computer Science, Business, health-related or related quantitative discipline, or equivalent healthcare experience
Type of Experience
Required: Minimum of one year performing encounter data analysis of RAPS, EDPS & APD, in a health care or health plan organization