Capital Blue Cross logo
Capital Blue Cross

At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.” We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital, you will work alongside a caring team of supportive colleagues and be encouraged to volunteer in your community. We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you develop your career. And by doing your best, you’ll help us live our mission of improving the health and well-being of our members and the communities in which they live.

Healthcare Encounter Submissions Data Analyst

Data AnalystData AnalystFull TimeRemoteSeniorTeam 1,001-5,000Since 1938H1B SponsorCompany SiteLinkedIn

Location

Pennsylvania

Posted

21 days ago

Salary

$63.4K - $119.4K / year

Seniority

Senior

Bachelor Degree3 yrs expEnglish

Job Description

• Support Capital Blue Cross Risk Adjustment Medicare submissions and day-to-day analytics activities that impact the Medicare submission process • Assist and/or develop new reports or analysis, enhance key existent reports and/or analysis processes, and methodologies of the Risk Adjustment Program operations and initiatives • Support the implementation and on-going activities of vendor operations and analytics tools • Lead the error correction process to ensure maximum acceptance rates for encounter submissions • Develop standardized reporting and controls for vendor’s management and performance monitoring process to ensure appropriate and timely data flow between teams • Collaborate with Actuarial to monitor the impact of coding programs on revenue for forecasting and monthly financial statement accruals

Job Requirements

  • 3 years of experience in risk adjustment and data analytics
  • Highly skilled in Excel, SAS, Power BI, Snowflake, Sigma and other query/reporting tools
  • Financial analytics knowledge with data mining principles: predictive analytics, mapping, collecting and complex manipulating data from multiple data systems
  • Preferred: Bachelors or master's degree in Data Analytics, Data Science, Finance, Actuarial, Mathematics or Statistics, Public Health or Health-related Sciences, or Health Administration

Benefits

  • Medical, Dental & Vision coverage
  • Retirement Plan
  • Generous time off including Paid Time Off
  • Holidays
  • Volunteer time off
  • Incentive Plan
  • Tuition Reimbursement

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