JOB SUMMARY:Under the direction of the Director, Medicare Operations:|
Responsible for CMS reporting and data management including but not limited to employer group reporting, organization determination and reconsideration reporting, agent reporting (including compensation schedule, testing, training, and oversight). Reconciles data and reporting from multiple systems (e.g., Telemagic, Facets, Amisys, Ika). Constantly monitors the status of new, existing, and previous reporting situations. Performs Mock Audits of all data reported to CMS at least annually. Performs other duties as assigned.
Minimum Education: Bachelor's degree or equivalent combination of education and experience. Bachelor's degree preferred.
Minimum Experience: Must have previous experience and knowledge of database systems. Experience in a business environment involving the analysis of financial or member data.
" Demonstrated problem-solving and analytical abilities.
" Ability to identify, extract, massage and analyze detailed data from multiple databases and sources. Ability to organize and present data effectively.
" Proficient in Advanced Excel and Access functions.
o Proven ability to create formulas for financial calculations
o Proven database development; ability to write queries and create macros
" Intermediate processing skills for use in data warehouse applications, including ability to identify appropriate data fields and write queries to obtain accurate information.
" Intermediate Microsoft Word
" Self directed and motivated.
" Ability to work independently, as well as part of the team and prioritize multiple assignments.
" Proven ability to work on multiple projects simultaneously and meet deadlines.
" Demonstrated ability to work independently with strong attention to detail.
" Demonstrated excellent written and verbal communication skills.
" Extensive reading to stay abreast of the frequent changes in federal and/or state regulations.
" Minimal travel required.
" Experience working with external parties, vendors or government agencies.
" Knowledge of Centers for Medicare and Medicaid Services (CMS) guidelines.
" Knowledge of revenue and data issues relating to Medicare.
" Knowledge of Impromptu, Business Objects, SQL.
" Previous Health Insurance experience.
MVP Health Care - 21 months ago