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Benefit Analyst Salary in Raleigh, NC

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HSAG analysts in the Data Science & Advanced Analytics division assist in designing a wide array of analytic studies and participate in all phases of the research design process. Analysts may work with a wide array of data to facilitate data exploration, including (but not limited to) the following data types:surveycase reviewmedical and prescription drug claims and encounterseligibilitydemographicclinicalelectronic health recordregistryvital statisticsoperationalDetails regarding potential project assignments and key sources of data will be discussed with candidates during the interview process.ESSENTIAL COMPETENCIES, DUTIES, AND RESPONSIBILITIESServe as an integral part of HSAG Data Science & Advanced Analytics division.Lead small- to medium-sized analytic tasks or projects, while providing support to other analytic tasks or projects.Understand primary types of healthcare data and methods for approaching data assessments.Evaluate a wide array of data types.Conduct and interpret analyses, develop appropriate statistical models, manipulate complex databases, and track and evaluate patterns of care and outcomes.Perform data validation, develop and implement analytic plans, and cross reference data.Attend, participate, and assist in team training meetings.Present and communicate project results to nonanalytic staff members and customers. 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SAS certification preferred.Proficient in the use of SQL.Experience working with relational databases.Experience contributing to report writing and formal written deliverables, including serving as the lead writer/major contributor to a formal written deliverable.Some proposal experience in a supporting role.Some experience mentoring junior-level staff.Proficient in Microsoft Word and Excel.Excellent verbal and written communication skills.Ability to handle several projects simultaneously and work with multiple teams.WORK ENVIRONMENTThe work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.DISCLAIMERThis is not necessarily an exhaustive list of all responsibilities, skills, duties, requirements, efforts or working conditions associated with the position. While this is intended to be an accurate reflection of the current position, management reserves the right to revise the position or to require that other or different tasks be performed when circumstances change (e.g., emergencies, changes in personnel, workload, rush jobs requiring non-regular work hours, or technological developments).HSAG is an EEO Employer of Veterans protected under Section 4212. If you have special needs and require assistance completing our employment application process, please feel free to contact us.EOE M/F/Vet/DisabledGet job alerts by email.Sign up now!
Systems Analyst - Remote
Allscripts, Raleigh
AllscriptsWelcome to Veradigm, where our Mission is transforming health, insightfully. Join the Veradigm team and help solve many of todays healthcare challenges being addressed by biopharma, health plans, healthcare providers, health technology partners, and the patients they serve. At Veradigm, our primary focus is on harnessing the power of research, analytics, and artificial intelligence (AI) to develop scalable data-driven solutions that bring significant value to all healthcare stakeholders. Together, we can transform healthcare and enable smarter care for millions of people.Veradigm is an innovative Healthcare Analytics and Technology Company that delivers visibility and transparency for Risk Adjustment and Quality Management programs. We enable health plans and at-risk providers to achieve the greatest financial impact in the Health Insurance Exchange (HIX), Medicare Advantage, and Medicaid markets. By combining advanced analytic methodologies with extensive health plan experience, Veradigm has developed a suite of uniquely pragmatic solutions that are revolutionizing risk adjustment. Veradigm flexible business intelligence tools offer real-time visibility into member and provider activities so our clients can apply the most cost-effective and appropriate interventions for closing gaps in documentation, coding, and quality.Job SummaryThe Systems Analyst works primarily with enterprise customers of Veradigms Encounter Management Platform, proactively assisting them with post- sales installation, configuration, upgrade, troubleshooting and day to day operational management. Responsibilities include taking a proactive leadership role working with the Engineering team and Customers to triage and resolve highly complex, technical, and application-related issues which impact product performance in customer-specific environments, or issues that directly hamper a broader customer adoption of Veradigms Encounter Management Platform. In addition to working with customers, the Systems Analyst will routinely partner with our Development, Sustaining Engineering and Sales Engineering organizations to resolve support issues, document bugs, provide UAT on product builds, and ensure that new and newly upgraded server installations are successful.This is a remote role.What you will contribute:Support encounter data reporting processes for EDPS, RAPS and the EDGE server, including tracking, reporting, and resolving rejectionsConduct gap analysis and data validation, identifying possible issues in data submission and determining financial impact.Analyze and reconcile claims and encounter data which will include 837 EDI encounter files for EDPS, RAPS and Edge Server submission filesPerform research in the encounter management system and liaison with the CSSC Helpdesk for exception resolutionBe comfortable with raw data files in their native format and accessing these through various serversPartner with Product Support Engineers and development teams as necessaryAssist development team with performance analysis and testing during release cycles for service packs, hot fixes etcAnswer email and phone requests for help from customersCollaborate in virtual teamwork with other Product Support staffHost online troubleshooting and investigation sessions on customers production environmentsDeliver a consistent, responsive and satisfying customer experience with each contactCollect all necessary problem details from customers to be able to effectively see the problem to resolutionSuccessfully reproduce customer issues in a controlled test environmentFollow standard operational procedures for case managementContinuously improve troubleshooting skills, product expertise, and knowledge on related technical topicsPerform ACA and MA Submissions for ClientsUnderstand RAPS and EDPS filtering logic which CMS uses for Risk Adjustment and/or Risk Score calculationsMonitor CMS data submission deadlines for both MA and ACA lines of businessThe ideal candidate will have:Academic and Professional Qualifications: Bachelors Degree in Health IT/Informatics/Management Information Systems or related field requiredExperience:2+ years of professional experience in Risk Adjustment data managementUnderstanding of claims data, encounter response files, 837 EDI encounter files, EDGE/MA billing & business rules as well as MA filtering logic for EDPSExperience with CMS Submissions Process and EDI transactionsExcellent time management and organizational skills necessaryPrior experience troubleshooting performance problems that may have many underlying causes such as Disk, Database, Network, Messaging and other platform / 3rd party solutionsExperience with managing product back end and webservicesAbility to guide customers remotely through complex, multi-server deployments and upgrades for enterprise productsFamiliarity with EDI Standards such as X12, EDIFACT, HL7, NCPDP and knowledge of HIPAA transactionsPrior knowledge of 837s along with various loops and segments and an understanding of the requirements set forth by CMS for EDPS submission filesWorking knowledge in SQL scripts is a plusGood written and verbal skills.Knowledge in CMS model changes is a plusKnowledge in CMS Risk Score and Risk Adjustment methodologies is a plusKnowledge in Medicaid is a plusTravel Requirements:Will travel to Company head quarter for new hire orientation and if there are any specific training or customer meetings.Working Arrangements:Monday through Friday or as defined by assignment requirementsCompliance Job responsibilities include fostering the Companys compliance with all applicable laws and regulations, adherence to the Code of Conduct and Compliance Program requirements, policies and procedures. Compliance is everyones responsibility. #LI-REMOTE#LI-KB1 Enhancing Lives and Building CareersVeradigm believes in empowering our associates with the tools and flexibility to bring the best version of themselves to work and to further their professional development. Together, we are In the Network. Interested in learning more?Take a look at our Culture, Benefits, Early Talent Program, and Additional Openings.We strongly advocate that our associates receive all CDC recommended vaccinations in prevention of COVID-19.Visa Sponsorship is not offered for this position.At Veradigm, our greatest strength comes from bringing together talented people with diverse perspectives to support the needs of healthcare providers, life science companies, health plans, and the patients they serve. The Veradigm Network is a dynamic, open community of solutions, external partners, and cutting-edge artificial intelligence technologies that provide advanced insights, technology, and data-driven solutions. Veradigm offers a comprehensive compensation and benefits package, including holidays, vacation, medical, dental, and vision insurance, company paid life insurance and retirement savings.Veradigms policy is to provide equal employment opportunity and affirmative action in all of its employment practices without regard to race, color, religion, sex, national origin, ancestry, marital status, protected veteran status, age, individuals with disabilities, sexual orientation or gender identity or expression or any other legally protected category. Applicants for North American based positions with Veradigm must be legally authorized to work in the United States or Canada. Verification of employment eligibility will be required as a condition of hire. Veradigm is proud to be an equal opportunity workplace dedicated to pursuing and hiring a diverse and inclusive workforce.From a "VEVRAA Federal Contractor" We request Priority Referral of Protected VeteransThis is an official Veradigm Job posting. To avoid identity theft, please only consider applying to jobs posted on our official corporate site.Thank you for reviewing this Veradigm opportunity. PI241883386
Reclamations Analyst
Stride, Inc., Raleigh
Job DescriptionThe Reclamation Analyst serves as the primary point of contact for the daily coordination of logistics associated with student computer hardware reclamation processes. The Reclamation Analyst is part of the Customer Support Operation team in the Enrollment Center, a diverse and fast-paced environment that serves our customers throughout their journey with K12. This role assists in retrieving K12 Loaner technology for the purposes of refurbishment. The Reclamations Analyst will utilize technical skills in K12 systems and work collaboratively with other critical teams at K12. Business hours for the team are from 8:00AM -8:00PM ET Monday- Friday.Required Certificates and Licenses: None Required.Requirements: Remote Worker, U.S. residents of the 50 states, and D.C. NOTE: We anticipate this position will pay $16.50 per hour. This is a temporary/contractor role, and you will be an employee of Randstad. The Reclamation Analyst serves as the primary point of contact for the daily coordination of logistics associated with student computer hardware reclamation processes. The Reclamation Analyst is part of the Customer Support Operation team in the Enrollment Center, a diverse and fast-paced environment that serves our customers throughout their journey with K12. This role assists in retrieving K12 Loaner technology for the purposes of refurbishment. The Reclamations Analyst will utilize technical skills in K12 systems and work collaboratively with other critical teams at K12. Business hours for the team are from 8:00AM -8:00PM ET Monday- Friday.ESSENTIAL FUNCTIONS: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.· Process all hardware reclamation label requests using the Customer Relationship Management (CRM) system and direct emails· Process assigned service requests using the CRM for status updates, fulfillment requests and tracking information· Provide daily reclamation and cancellation files to vendor; updates master files· Work with schools and teachers directly to reclaim computers;· Process live inbound calls from auto dialer batch· Make live outbound calls to recover hardware· Handle vendor cancelled recoveries· Manage reclamation email inbox for all types of requests and escalations from schools, teachers, and familiesSupervisory Responsibilities: This position has no formal supervisory responsibilities.MINIMUM REQUIRED QUALIFICATIONS:· High School diploma AND· One (1) year of experience in operations, administration or other relevant work OR· Equivalent combination of education and experienceCertificates and Licenses: None required.System Requirements:· Our work from home members are required to have and maintain High-speed internet connection. At the minimum 50Mbps download speed and 10Mbps upload speed, if not competing with other household users. For the sake of call quality, satellite, DSL, data plans, wireless or dial-up services are not compatible.· Some Internet service providers enable what is called SIP ALG (Session Initiation Protocol Application Layer Gateway). This interferes with our systems and must be disabled by the provider.· Ethernet connection is preferred.OTHER REQUIRED QUALIFICATIONS:· Ability to communicate with customers effectively through various communication channels, such as: phone, voicemail, email, chat, etc.· Physical requirements: sedentary work, fluent typing, listening, speaking, extensive reading, repetitive motions, and extended computer usage.· Own or have daily access to a smart device where Apps can be downloaded/accessed (i.e., phone, tablet)· Ability to maintain a professional home office without distraction during our hours of operation· Attend virtual training via webcam· Own or have daily access to a smart device where Apps can be downloaded/accessed (i.e., phone, tablet)· Microsoft Office (Outlook, Word, Excel, PowerPoint, etc.); Web proficiency.· Strong verbal and written communication skills· Consultative approach to customer service· Strong problem solving and analytical skills with a solutions-oriented approach· Ability to work independently and within a team-oriented environment· Resilient and contributes to fostering positive team morale· Ability to prioritize effectively and manage competing priorities to deliver and drive results· High level of quality and accountability for work product· Ability to travel 10% of the time (minimal if any e.g. team building event)· Ability to clear required background checkDESIRED QUALIFICATIONS:· Salesforce Experience· Prior Stride/K12 Enrollment Center Experience· Pervious customer service or sales experience with proven record of achievement· Previous experience in a call-center environment· Experience with Stride/K12 Systems such as TotalView Suite, SAMS, Calabrio, etc.WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.· This is a remote, work-from-home (WFH), position and open to residents of the U.S. 50 states and D.C.Compensation & Benefits:Stride, Inc. considers a person's education, experience, and qualifications, as well as the position's work location, expected quality and quantity of work, required travel (if any), external market and internal value when determining a new employee's salary level. Salaries will differ based on these factors, the position's level and expected contribution, and the employee's benefits elections. Offers will typically be in the bottom half of the range.We anticipate this position will pay $16.50 per hour. This is a temporary/contractor role and you will be an employee of Randstad. This salary is not guaranteed, as an individual's compensation can vary based on several factors. These factors include, but are not limited to, geographic location, experience, training, education, and local market conditions. Randstad offers a robust benefits package for eligible employees that can include health benefits, retirement contributions, and paid time off.Job TypeContractorThe above job is not intended to be an all-inclusive list of duties and standards of the position. Incumbents will follow any other instructions, and perform any other related duties, as assigned by their supervisor. All employment is "at-will" as governed by the law of the state where the employee works. It is further understood that the "at-will" nature of employment is one aspect of employment that cannot be changed except in writing and signed by an authorized officer.Stride, Inc. is a Federal Contractor, an Equal Opportunity/Affirmative Action Employer and a Drug-Free Workplace. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected Veteran status age, or genetics, or any other characteristic protected by law.Equal Opportunity Employer/Protected Veterans/Individuals with DisabilitiesThe contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)
Analyst I - REMOTE
Health Services Advisory Group, Inc., Raleigh
Job DetailsSUMMARYHSAG is nationally recognized as an industry leader in the areas of healthcare data analysis, measure development, and survey research. We are in search of talented individuals who are interested in a career in analytics as an Analyst I in HSAG's Data Science & Advanced Analytics division. Together we can spread positive change to make healthcare better. UNIQUE BENEFITSThe Analyst I position benefits from HSAG's desire to grow its staff into leaders of healthcare quality improvement in the nation. During the first year, new HSAG analysts are provided formal internal training in statistics, machine learning, clinical epidemiology, SAS, Tableau, healthcare data, and an assortment of healthcare-related topics. The Analyst I will also have the opportunity to participate in company-sponsored training with the SAS Institute.HSAG offers:A comfortable work-life balance, including half-day Fridays and flexible work schedules.Three weeks of paid time off and 15 company-paid holidays where staff leave two hours early prior to each holiday to get a "jump start" on holiday festivities.HSAG offers a competitive benefit package that includes medical, dental, vision, tuition reimbursement, and 401(k). DESCRIPTIONThe Analyst I position is a key contributor to cutting-edge analytic work that spans the broad spectrum of healthcare data projects at HSAG. Driven by intellectual curiosity and a passion for healthcare quality, the Analyst I position supports innovative analytic plans that are intended to provide healthcare decision and policy makers with the necessary information to transform healthcare. HSAG analysts within the Data Science & Advanced Analytics division assist in designing a wide array of analytic studies and participate in all phases of the research design process. Analysts may work with a wide array of data to facilitate data exploration, including (but not limited to) the following data types:surveycase reviewmedical and prescription drug claims and encounterseligibilitydemographicclinicalelectronic health recordregistryvital statisticsoperationalDetails regarding potential project assignments and key sources of data will be discussed with candidates during the interview process.ESSENTIAL COMPETENCIES, DUTIES, AND RESPONSIBILITIESServe as an integral part of HSAG Data Science & Advanced Analytics division.Exhibit the ability to learn about the primary types of healthcare data and methods for approaching data assessments.Exhibit the ability to learn efficient SAS programming skills.Evaluate a wide array of data types.Conduct and interpret analyses, develop appropriate statistical models, manipulate complex databases, and track and evaluate patterns of care and outcomes.Perform data validation, conduct analysis plans, and cross reference data.Attend and participates in team training meetings.Present and communicate project results to nonanalytic staff members and customers. Represent HSAG in a professional manner at all times.Compensation: $70,000 - $75,000 - Depending upon experienceJob Requirements:EDUCATION AND/OR EXPERIENCEBachelor's degree in a quantitative discipline (e.g., math, statistics, economics, and epidemiology). Master's degree preferred. OTHER QUALIFICATIONSCoursework completed in statistics and other quantitative coursesKnowledge of statistical programming in at least one software language.Experience working with relational databases.Proficient in Microsoft Word and Excel.Excellent verbal and written communication skills.Ability to handle several projects simultaneously and work with multiple teams.WORK ENVIRONMENTThe work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.DISCLAIMERThis is not necessarily an exhaustive list of all responsibilities, skills, duties, requirements, efforts or working conditions associated with the position. While this is intended to be an accurate reflection of the current position, management reserves the right to revise the position or to require that other or different tasks be performed when circumstances change (e.g., emergencies, changes in personnel, work load, rush jobs requiring non-regular work hours, or technological developments).HSAG is an EEO Employer of Veterans protected under Section 4212. If you have special needs and require assistance completing our employment application process, please feel free to contact us.EOE M/F/Vet/DisabledGet job alerts by email.Sign up now!