OverviewThis position is responsible for general support and functionality within the Sentara Health Plan Encounters Team and the Encounters submission process.  This position will operate under the guidance of Sr. Business Analysts and the Encounters Leadership Team to address and satisfy State, Federal, and Internal imperatives.General Duties / Responsibilities to include, but are not limited to:Coordinate with other Encounters Department team members in the preparation, validation, and submission of adjudicated claims data (“Encounters”), to both state and federal agencies.Under general supervision, train and develop proficiencies in data analysis techniques relating to Encounters submission data received by the Health Plan from state and federal agencies.Work with Sr. Business Analysts to coordinate efforts to identify, analysis, and remediate identified errors via reprocessing,Over time, develop sufficient operational expertise (systems and tools, methodologies, contractual / technical requirements) to support the Encounters workstream actively and competently in all major operational areas (data requirements, data structure, submissions, and remediation)Establish and maintain working relationships with peers, key departmental stakeholders, and external servicing vendors relating to assigned Market(s) / Lines of Business (LOBs).Partner with Sr. Business Analysts and the Encounters Leadership Team in ongoing efforts to establish, maintain, and incorporate improvements to departmental documentation needs (task schedules, submissions tracking, Standard Operation Procedures (SOPs)Assist Sr. Business Analysts and the Encounters Leadership Team in ongoing User Acceptance Testing (UAT) needs relating to internal systems upgrades, configuration changes, and new vendor / LOB implementations.

EducationBachelor's Degree preferred.Certification/LicensureNo specific certification or licensure requirements

Experience

Must Have :

Three years' of related experience is required in one of the following areas: Operations, IT or Reporting.Strong attention to detail and accuracy in reporting, data validation, and documentation

Nice to have:

Experience with healthcare data and systems, including Encounter data, 837/834 transactions, EDI, and related reportingExperience with SQL, Power BI, and Databricks to support analytics, reporting, and data validationExperience supporting UAT(User acceptance testing), Root Cause Analysis (RCA), and project-based initiatives

We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay rate for Full Time employment is:$60,756.80-$101,254.40. Additional compensation may be available for this role such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.