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Medicaid Experience Salesforce CRM Excellent Communication Skills Analyst
(Jobs
 
Requirement id 70064
Job title Analyst
Job location in Baltimore, MD
Skills required Health Care Systems, not found, 834 EDI File Format, Medicaid Experience Salesforce CRM Excel
Open Date 22-May-2018
Close Date
Job type Not specified
Duration 36 Months
Compensation DOE
Status requirement ---
Job interview type ---
   Email Recruiter: coolsoft
Job Description Analyst: Health Care Systems, not found, 834 EDI File Format, Medicaid Experience Salesforce CRM Excel

Submission Deadline: 6/5/2018 12:00 p.m.
Start date: 7/1/2018
End date: 6/30/2021

Client: Maryland Health Benefit Exchange (MHBE)

Description:

The Maryland Health Benefit Exchange (MHBE) created a website and call center operating under the name Maryland Health Connection (MHC). Through MHC, Maryland residents explore health insurance plans, compare rates, and determine their eligibility for advanced premium tax credits (APTC), cost sharing reductions (CSR) and public assistance programs such as Medicaid and the Maryland Childrens Health Insurance Program (MCHP).
MHBE seeks up to four (4) Research Analysts to provide research and analysis support services to reconcile the Enrollment Transactions (8001 transactions) between the Health Benefit Exchange (HBX) system and the Maryland Medicaid Management and Information Systems (MA-MMIS), and to resolve and track the 834 Benefit Enrollment and Maintenance records data with the Carriers and Managed Care Organizations (MCO).

Research into the 8001 Enrollment Transactions generated out of HBX system for identifying any missing mandatory data.
Identify the best match for the Individual Registration Number (IRN) by accessing and analyzing data from multiple systems across MHBE, DHR and DHMH.
Analyze and reconcile the HBX 8001 transactions with the MMIS application.
Analyze data errors and track 834 Benefit Enrollment and Maintenance records in the HBX system.
Utilize data matching and correction protocols to process escalated system errors to process high volumes of data reconciliation efforts on a daily basis.
Research into Member Level Record (MLR) data from the Carriers, obtain additional information from the consumers, analyze and resolve 834 escalated cases.
Research into MA 8001 data and EDI 834 data sent to the MCOs, EDI 999 error report received from the consumers, analyze and resolve 834 MA escalated cases.
Analyze and collate data from daily 8001, 834 error reports and Interim Database (IDB), to produce data reconciliation and escalation reports for the MHBE EDI, Call Center and Case Management teams.
Research 834 and 8001 escalated cases using CRM records, and update CRM records upon resolution.

Minimum Qualifications
A minimum of two (2) years of experience working with the federal or state based health care systems.
Proficiency using Microsoft Office Suite (MS Word and MS Excel).
Working knowledge of the basic database functionalities, EDI 834/999 structure and Medicaid MA 8001 transactions.
Experience using Salesforce CRM.
Ability to analyze and interpret data and organize information into reports or presentations.
Excellent communication skills, problem solving skills, knowledge retention skills and listening abilities.
Demonstrated ability to understand system application functionality.
Minimum Qualifications
A minimum of two (2) years of experience working with the federal or state based health care systems.
Proficiency using Microsoft Office Suite (MS Word and MS Excel).
Working knowledge of the basic database functionalities, EDI 834/999 structure and Medicaid MA 8001 transactions.
Experience using Salesforce CRM.
Ability to analyze and interpret data and organize information into reports or presentations.
Excellent communication skills, problem solving skills, knowledge retention skills and listening abilities.
Demonstrated ability to understand system application functionality.

Preferred Qualifications
The additional Experience/Knowledge/Skills listed below are preferred by the MHBE.
Research Analyst
A minimum two (2) years of experience supporting MMIS and/or HBX applications.
Knowledge of the Affordable Care Act (ACA).
Prior experience in resolving consumer and carrier related healthcare escalated cases.
Knowledge of the Affordable
 
Call 502-379-4456 Ext 100 for more details. Please provide Requirement id: 70064 while calling.
 
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(Analyst: Health Care Systems, not found, 834 EDI File Format, Medicaid Experience Salesforce CRM Excel in Baltimore, MD)
     
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