Job Description:

Description:

This position is part of the Blue Shield Promise Encounters Data Analysis within Finance Department and will work within a team to support daily encounter data operations. The Analyst will provide essential support to all functions within the team including: (1) creation of dashboard / reports to support the encounter submission team (2) Conduct analysis into data mission and determine resolution path for issues. (3) Support various projects to completion ensuring timely and accurate implementation. (4) Optimize existing processes to support department priorities.

To create an effective team, every individual must have:

- The desire to support Blue Shield Promise's missions, goals and the member population which we serve.

- Excellent interpersonal/communication skills across various media (written, verbally in meetings and over-the-phone).

- The ability to engage and collaborate with others in a team setting to successfully complete projects.

- The ability to prioritize and manage projects/timelines to achieve successful outcomes.

- Detail-oriented.

- Have strong analytical skills.

- The ability to work in a fast-paced environment with dynamic work demands.

Essential Functions and Key Responsibilities:

- Responsible for conducting analysis of encounter data submission volume, quality and timeliness. Identify submission trends and perform root cause analysis. Report findings, accomplishment, trends, deficiencies and solutions.

- Responsible for creation of dashboards / reports via various analytic tools (Tableau / SAS / etc).

- Responsible for undertaking and driving various projects / efforts to support the encounter submissions.

- Stay current with regulatory reporting requirements and identify the opportunities to enhance and optimize the processes and submission performance.

- Work with various internal and external stakeholders, consultants and industry experts to implement best-in-class dashboard / reports in an accurate and timely manner.

Education:

- Requires minimum of a bachelor's degree, with a preference for master's degree.

Skills:

- Excellent interpersonal, verbal and written communication and presentation skills - especially presentations of complex, technical information to non-technical audiences and from non-technical information to technical information.

- Independent problem solver, proactive, able to multitask. Patience for working on large scale problems.

- Proficient in SQL / SAS / Tableau and other data/analytic tools.

- Proficient with EDIFECS software and EDIFECS reporting.

- Proficient with MS Office (Excel, Word, PowerPoint and Visio).

Preferred experience:

- Knowledge of healthcare management in Provider Relations, Contracting, Member Enrollment, Claim Process, Medical Payment and Revenue Reporting, and Encounter submissions and measures.

- Experience with State and Federal regulatory data standards and requirements.

- Experience with HIPAA standard EDI transaction sets, specifically 837P, 837I, 837D, NCPDP 4.2, 277CA, and 999.

Additional Information

- Our Company: At Blue Shield of California we are parents, leader, students, visionaries, heroes, and providers. Everyday we come together striving to fulfill our mission, to ensure all Californians have access to high-quality health care at a sustainably affordable price. For more than 80 years, Blue Shield of California has been dedicated to transforming health care by making it more accessible, cost-effective, and customer-centric. We are a not-for-profit, independent member of the Blue Cross Blue Shield Association with 6,800 employees, more than $20 billion in annual revenue and 4.3 million members. The company has contributed more than $500 million to Blue Shield of California Foundation since 2002 to have a positive impact on California communities. Blue Shield of California is headquartered in Oakland, California with 18 additional locations including Sacramento, Los Angeles, and San Diego. We're excited to share Blue Shield of California has received awards and recognition for - LGBT diversity, quality improvement, most influential women in corporate America, Bay Area's top companies in volunteering & giving, and one of the world's most ethical companies. Here at Blue Shield of California, we're striving to make a positive change across our industry and the communities we live in - Join us!

- Physical Requirements:
Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

- Equal Employment Opportunity: External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.

- Requisition ID: 20001X3

- Posting Date: Aug 1, 2020

- Schedule: Full-time

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