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Agency Operations Associate/Data Analyst

Summary: The Agency Operations Associate/Data Analyst is responsible for managing the information received by the State Medicaid Agencies and internal business units. This individual must possess robust Excel and Access Database skills and be a competent, highly motivated, and independent person.  The role requires a high sense of ownership of assigned requests and ability for problem-solving.  Must establish and maintain communication with business personnel keeping them updated with the status of requests, as well as proactively escalating issues that cannot be resolved within established timeframes. This Associate/Data Analyst will function as the data liaison between various Medicaid agencies and internal stakeholders. Additionally, this position will involve establishing/maintaining relationships with a number of Medicaid Agencies through regular communication and follow up to ensure responsiveness to both internal and external clients.

Responsibilities:

  • Format, catalog, convert, analyze and store incoming data transmissions from Medicaid agencies for import into business applications*
  • Prepare and manipulate data files for internal processes*
  • Review data and file entry for accuracy, completeness, and validity, including the review of rejected files and errors.
  • Ensures integrity of information through preparing and maintaining accurate data*
  • Works with IT, Program Managers and Medicaid Operations Manager, as appropriate*
  • Creates and distributes a variety of reports as required and generates ad-hoc reporting as appropriate*
  • Assists in distribution and prioritization of claims to ensure project milestones are met*
  • Responds to requests by Program Managers by providing effective and timely updates*
  • Actively participates in the development of departmental procedures and process documentation*
  • Regularly participates in meetings and is dependable as an internal/external resource on assigned projects*
  • Coordinates and builds relationships with Medicaid Agencies*
  • Understands and communicates audit protocol process to Medicaid Agencies*
  • Works with Medicaid Agencies to determine entitlement, secure claims and obtain approvals for audited claims in a timely manner*
  • Follows up with Medicaid Agencies as appropriate to obtain missing requests, resolve discrepancies, explain audited claim results and other issues as required*
  • Other responsibilities as assigned

Requirements:

  • Associate or Bachelor’s degree in relevant field or equivalent work experience.
  • 1-2 years of experience in data management.
  • Advanced MS-Excel skills, including macros, pivot tables, and v-lookups.
  • Excellent attention to detail
  • Ability to orchestrate large volumes of data, while meeting critical deadlines
  • Problem solving and strong analytical skills
  • Effective communication skills, written, oral and listening
  • Strong internal and external client service skills
  • Must be resilient and able to handle rejection, while assertively following up to bring open issues to closure
  • Ability to work independently and make decisions with minimal supervision.
  • Ability to adapt to fast-paced/constantly changing environment
  • Preferred Candidates would also meet the following criteria:
  • Experience with healthcare and/or payment data processing.
  • Experience with VBA scripting abilities for Excel programming.
  • Knowledge of healthcare data privacy and HIPAA compliance requirements.

 

 

 

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