Business Analyst-ACA Data Submission
Company: Vernus Technologies
Location: Grand Rapids
Posted on: February 22, 2021
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Job Description:
Description:**100% remote position ** Job Summary Under direct
supervision, the Business Analyst is responsible for preparing and
ensuring accuracy of enrollment and claims data required for
submission to CMS. Will be skilled at creating and running reports
from multiple databases; identifying and correcting discrepancies
and analyzing root causes of data errors. Candidate will possess
strong analytical skills and ability to work with many departments
and vendors. Will also assist with ACA RADV Audit activities.
Knowledge of the HHS Risk Adjustment process is recommended. Job
Responsibilities--- Prepare monthly medical and pharmacy claims and
enrollment queries for submission to CMS EDGE Server--- Determine
root cause of discrepancies by understanding the business logic
used for the EDGE Server--- Resolve enrollment and claims
discrepancy errors and work with report developer to identify logic
changes required with the queries--- Review CMS Response reports
for risk adjustment gaps--- Support RADV audit analysis and provide
demographic and enrollment documentation and pharmacy claim
documentation in the appropriate format--- Support of ACA risk
adjustment tasks related to system integration--- Other duties as
assigned Qualifications--- Bachelor's degree in business or health
care field--- 3 years of experience working with Health Plan
enrollment or claims transactions--- Knowledge of the Affordable
Care Act Individual Health Plan regulations--- Experience with CMS
guidelines for data submission--- Experienced with Microsoft Excel
and Microsoft Access analysis and functions--- Knowledge of HHS
Risk Adjustment process--- Ability to collaborate effectively and
work as part of a team and independently--- Strong Analytical and
Problem-Solving abilities--- Strong attention to detail--- Skilled
at written and oral communications - provided by Dice
Keywords: Vernus Technologies, Grand Rapids , Business Analyst-ACA Data Submission, Professions , Grand Rapids, Michigan
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