Data Analyst (Eligibility) Jobs

Performant Corporation is an Equal Opportunity Employer (Minorities/Females/Disabled/Veterans).

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Data Analyst (Eligibility)

Job Code: 2022-50-R-094

Location: United States - Remote

Status: Regular Full Time

Pay Range: 58400.00-87600.00

Responsibilities

The Eligibility Data Analyst is a data analytic with strong knowledge of healthcare eligibility, healthcare claims, medical terminology, eligibility validation practices, Coordination of Benefits and Third-Party Liability (COB/TPL), or Medicare Secondary Payer (MSP). This position will also support new client implementations and existing programs with requirements gathering related to eligibility and client data.

Essential Duties

• Review and analyze eligibility and client data to identify trends, patterns and identify impact across various products.
• Follows and complies with company, departmental and client program policies, processes, and procedures.
• Develops custom queries and reporting, conducts research, analyzes trends and activities, and presents data and findings based upon business needs and as need to identify opportunities, root causes of issues and to support business decisions and strategies.
• Successfully completes, retains, applies, and adheres to content in required training as assigned.
• Performs other duties as assigned.
• Assist technical and business leads with requirements gathering, documentation, and project management for new implementations and existing program changes.
• Conducts a variety of data analysis for intelligent insights using subject matter knowledge, independent judgement, and analytical expertise.
• Leverage knowledge and expertise in COB/TPL/MSP to review eligibility and client data.
• Completes required processes to obtain client required clearances as well as company regular background and/or drug screening; and successfully passes and/or obtains and maintains. clearances statuses as a condition of employment. (Note: client/government clearance requirements are not determined or decisioned by Performant.)
• Responsible for utilizing resources to ensure compliance with client requirements, HIPAA, as well as applicable federal or state regulations.
• Correct areas of deficiency and oversight received from quality reviews and/or management.
• Demonstrates Performant core values in performance of job duties and all interactions.

**Note**

All employees and contractors for Performant Financial may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times. Violations to Performant’s policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination.

Required Skills And Knowledge

• Experience with Medicaid / Medicare / Other TPL business models and products
• Strong system skills with ability to quickly develop expertise in new systems and applications
• Knowledge of and ability to work with large volumes of health care eligibility and claims data
• Able to work independently and meet deadlines with minimal supervision
• Professional verbal and written communication with good presentation skills
• Strong problem solving and communication (written and oral) skills
• Advanced skills in Excel, Access and/or other data analysis applications
• Advanced knowledge of X12 EDI Transactions, including, but not limited to 270/271, 834, 277, 837, 835
• Knowledge of requirements gathering, ETL processing and data matching
• Self-motivated and thrives in a fast-paced business operations department performing multiple tasks cohesively, with keen attention to detail
• Ability to produce results and maintain positive attitude in fast paced, dynamic environment
• Proficient SQL skills to query and test

Physical Requirements

• Job is performed in an standard busy office environment with moderate noise level (or may be home-office setting subject to Company approval and Teleworker Agreement), sits at a desk during scheduled shift, uses office phone or headset provided by the Company for calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a mouse.
• Sit/stand 8 or more hours per day; has the option to stand as needed while on calls; reach as needed to use office equipment.
• Occasionally lift/carry/push/pull up to 10lbs.
• NOTE: Must be able to meet requirements for and perform work assignments in accordance with Company policies and expectations on a home remote basis (and must meet Performant remote-worker requirements) until at which time staff will be notified and required to work from a Performant office location. Basic office equipment required to perform remote work is provided by the company.
• Consistently viewing a computer screen and types frequently, but not constantly, using a keyboard to update accounts.
• Consistently communicates on the phone as required primarily within the department and company and may include client contacts or other third-party depending on assignment with account holders, may dial manually when need or use dialer system; headset is also provided.
• Reads and comprehends information in electronic (computer) or paper form (written/printed).

Education And Experience

• Knowledge and experience with Healthcare, Coordination of Benefits, Third Party Liability, and/or Medicare Secondary Payer
• 5+ years relevant experience working with healthcare eligibility or client data
• Bachelor’s degree in relevant field or equivalent combination of education and experience.
• Experience with data modeling and analysis

Other Requirements

• Must submit to and pass drug screen pre-employment (and throughout employment).
• Must submit to and pass pre-hire background check, as well as additional checks throughout employment
• Must be able to pass a criminal background check; must not have any felony convictions or specific misdemeanors, nor on state/federal debarment or exclusion lists.
• Performant is a government contractor. Certain client assignments for this position requires submission to and successful outcome of additional background and/or clearances throughout employment with the Company.

Visa sponsorship is not available.

Job Profile is subject to change at any time.

EEO

Performant Financial Corporation is an Equal Opportunity Employer.

Performant Financial Corporation is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law.

NO AGENCY SUBMISSIONS WITHOUT PERFORMANT AUTHORIZED AGENCY AGREEMENT AND APPROVED PERFORMANT JOB ORDER