Job Description

Compensation: $50/hr to $57.06/hr. Exact compensation may vary based on several factors, including skills, experience, and education. Benefit packages for this role will start day 1 of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.

Must Have:

• Must sit in one of the following states:

Alabama, Delaware, Florida, Georgia, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington (State), West Virginia, Wisconsin, Wyoming

• 5 Years Experience in Cognizant EDM
• 5 Years Experience in Cognizant QNXT
• 5 Years Experience in Medicaid
• 5 Years 837 EDI Experience (i, p, d)
• 5 Years Experience with NCPDP Files
• Visionary - able to convert uncertainty and chaos into order (a well-built auditing program).
• Handles ambiguity with ease - will not be handed a solution and told to execute. This position will be handed a problem and asked to solve rapidly.
• Interface Management Experience
• Ability to read, understand, deeply interpret state technical manuals with ease - converting to actions, particularly when it come to Audit opportunities.
• Able to articulate encounters errors with ease, and can clearly walk through examples of errors that have occurred, upstream root causes, and systemic paths to resolution.
• Able to independently operate as an investigator to problems with Encounters.

Very Nice to Have:

• Primary focus is Virginia Medicaid. Ideally someone who fully understands state based complexities.
• Built or participated in an Encounter Audit Program

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