Medicare Advantage EDI Analyst
Job Posting for Medicare Advantage EDI Analyst at University of California - Los Angeles Health
DescriptionTake on a significant role within a world-class health organization. Elevate the operational effectiveness of a complex health system. Take your professional expertise to the next level. You can do all this and more at UCLA Health.
As an important member of our Medicare Advantage Operations team, you will be instrumental in maintaining and running processes/jobs for electronic claims and other EDI transactions. This will involve working with external trading partners, transferring/loading data through secure channels, and testing files from new providers/trading partners. You will be responsible for claim encounter data submissions and the coordination of business transactions for all HIPPA/CMS standard sets. You will focus on delivering operational efficiencies and meeting claim data submission requirements.
Salary Range: $71,500 - $154,900 Annually
QualificationsWe're seeking a self-motivated, detail-oriented, customer-focused leader with:
* Bachelor's degree in business, information systems, healthcare, or a related field, or a combination of equivalent education, training and experience required
* Five or more years of experience with CMS processes in a Medicare or managed care environment
* Must have 3-5 years of experience with Encounter submission (837 I, P, 999 and 277) to/from CMS is required
* Advanced proficiency with SQL, SSIS package, data visualization tools, and Microsoft Office
* Knowledge of physician and facility billing practices, appropriate CPT coding initiatives, ICD-10 coding standards, and revenue/HCPCS coding
* Extensive experience with claims encounter strategies and processes
* Knowledge of claims payment methodologies, adjudication processing, and Federal encounter regulations
* Knowledge of encounter regulatory reporting and compliance requirements
* Previous vendor management experience
* Ability to research and resolve encounter issues
* Understanding of the health care model, capitation, and other managed care IPA and provider reimbursement methodologies
* Excellent communication, interpersonal, analytical, and problem-resolutions skills
* Ability to modify and adapt operational procedures to changing operational needs
* Strong leadership, critical thinking, and prioritizing abilities
* Ability to develop, implement, and evaluate methods and systems to improve efficiency
* Ability to articulate ideas to both technical and non-technical staff
UCLA Health is a world-renowned health system with four award-winning hospitals and more than 260 community clinics throughout Southern California. We are also home to the David Geffen School of Medicine, a highly respected leader in the development of breakthrough medical research and outstanding clinical professionals. If you're looking to experience greater challenge and fulfillment in your career, you can at UCLA Health.
University of California is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age or protected veteran status. For the complete University of California nondiscrimination and affirmative action policy, see: UC Nondiscrimination & Affirmative Action Policy.
Salary.com Estimation for Medicare Advantage EDI Analyst in Los Angeles, CA
$87,613 to $110,929
If your compensation planning software is too rigid to deploy winning incentive strategies, it’s time to find an adaptable solution.
Compensation Planning
Enhance your organization's compensation strategy with salary data sets that HR and team managers can use to pay your staff right.
Surveys & Data Sets
Sign up to receive alerts about other jobs with skills like those required for the Medicare Advantage EDI Analyst.
Click the checkbox next to the jobs that you are interested in.
-
Accounts Receivable Skill
-
Income Estimation: $59,715 - $80,143
-
Income Estimation: $65,361 - $88,969
-
-
BI Analytics/Reporting Tools Skill
-
Income Estimation: $82,945 - $104,554
-
Income Estimation: $83,447 - $114,543
-
View Core, Job Family, and Industry Job Skills and Competency Data for more than 15,000 Job Titles
Skills Library
Job openings at University of California - Los Angeles Health
University of California - Los Angeles Health
Los Angeles, CA
Full Time
University of California - Los Angeles Health
Los Angeles, CA
Per Diem
University of California - Los Angeles Health
Los Angeles, CA
Full Time
University of California - Los Angeles Health
Los Angeles, CA
Full Time
Not the job you're looking for? Here are some other Medicare Advantage EDI Analyst jobs in the Los Angeles, CA area that may be a better fit.
We don't have any other Medicare Advantage EDI Analyst jobs in the Los Angeles, CA area right now.
Medicare Advantage EDI Analyst
UCLA Health Careers, Los Angeles, CA
Medicare Advantage Premium Billing Analyst
UCLA Health, Los Angeles, CA