Trillium Health Resources ยท 2 days ago
Encounter Data Analyst
Trillium Health Resources is a Tailored Plan and Managed Care Organization serving 46 counties across North Carolina. The Encounter Data Analyst is responsible for reviewing and monitoring adjudicated claims for submission and processing, ensuring compliance with service level agreements, and communicating with provider agencies regarding encounter submissions and denial management.
Child CareHealth CareMental HealthNon Profit
Responsibilities
Track adjudicated claims from received date to upstream encounter submission and verify response received from the Department
Review data flow between claim system and encounter file submissions; identify and report any discrepancies
Maintain documentation of failed/denied encounters and the communications associated with the follow-up performed to address the issues with internal staff and external provider agencies
Ensure Service Level Agreements (SLA) are met
Monitor Tailored Plan subcontractors claims and ensure all are submitted as encounters
Qualification
Required
High School Diploma or GED and two (2) years in processing medical information or data management and reporting; OR
Equivalent combination of education/experience
Must have a valid driver's license
Must reside within North Carolina
Must be able to travel within catchment as required
Preferred
Associate's degree in Information Technology, Statistics, Data Analytics, Business, or a Human Services field (such as Psychology, Social Work, etc.)
Experience in the areas of data analysis, data management, statistics, reporting, and use of databases
Benefits
Health Insurance with no premium for employee coverage
Flexible Spending Accounts
24 days of Paid Time Off (PTO) plus 12 paid holidays in your first year
NC Local Government Retirement Pension (defined-benefit plan)
401k with 5% employer match and immediate vesting
Public Service Loan Forgiveness (PSLF) qualifying employer
Quarterly stipend for remote work supplies
Company
Trillium Health Resources
Trillium Health Resources is a local governmental agency for individuals with serious mental health, and intellectual disability services.