Headquarters Office, 625 State Street, Schenectady, New York, United States of America

Rochester Office, 20 S. Clinton Ave, Rochester, New York, United States of America
Tarrytown Office, 303 South Broadway, Tarrytown, New York, United States of America
Virtual Req #1617

Thursday, November 30, 2023

Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full of opportunities to grow. We are a nationally recognized, award-winning leader for a reason. The beating heart of our company is a wide range of employees from a diverse set of backgrounds-tech people, numbers people, even people people-working together to make health insurance better. If you are ready to join a thriving, mission-driven company where you can create your own opportunities and make a positive difference-it's time to make a healthy career move to MVP!

Full-Time, Exempt

Summary

Responsible for the creation and accuracy of data extracts and reports, including but not limited to member eligibility, provider, medical & pharmacy encounters, and claim payment. Reconcile data and payment, and ensure complete, accurate and timely revenue within state and federal guidelines. Must constantly monitor the status of new, existing, and previous discrepancies or recovery situations. Actively participate in the development, testing and implementation of file extracts and layouts to meet vendor and regulatory agency requirements. Oversee the extraction, integrity, and submission of data. Analyze Federal and State programs to report trends and recommendations to management. Performs other duties as assigned.

Position Qualifications

Minimum Education:

Associates Degree in Health Administration, business, economics, computer science or related field. Related work experience will be considered in lieu of college degree.

Minimum Experience

2 years of experience in a business environment involving the analysis of financial, healthcare, member or other large complex data sets. Must have advanced SQL experience. Experience working with external parties, vendors, or government agencies.

Required Skills:

SQL and Microsoft Excel (advanced) required
Demonstrated understanding of relational database concepts including ability to manipulate raw data into meaningful, objective information
Proven ability to pull, analyze, report, and provide insight on large complex sets of data
Ability to identify areas of process improvement and implement automation efficiencies
Demonstrated problem-solving and analytical abilities
Experience working in a routinely audited environment
Ability to work independently, as well as work effectively as a member of a team.
Demonstrated excellent written and verbal communication skills
Experience with Microsoft Word and Excel
Extensive reading to stay abreast of the frequent changes in federal and/or state regulations

Preferred Skills:

Previous Health Insurance experience
Python
Experience in partnering with vendors to accomplish work objectives
Working knowledge of Risk Adjustment
Working knowledge of ICD-10, CPT, HCPCS and revenue codes.
Knowledge of Centers for Medicare and Medicaid Services (CMS) and state agency guidelines.
Knowledge of revenue and data issues relating to CMS/HHS & state agencies
Experience using data analysis and visualization tools such as Power BI
Ability to create testing procedures and policies for updated processes
Experience working in an agile framework

About MVP

MVP Health Care is a nationally recognized, not-for-profit health insurer caring for members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal. We are powered by the ideas and energy of more than 1,700 diverse employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve.

At MVP, we are committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. Specific employment offers and associated compensation will be made individually based on several factors , including but not limited to geographic location ; relevant experience, education, and training; and the nature of and demand for the role.

In addition, we offer a comprehensive benefits package that includes:

Considerable paid time away from work including PTO (Paid Time Off), s ick t ime, service t ime o ff, p aid h olidays, and f loating h olidays , allowing you to take time off when it suits you best.
Competitive 401(k) employer matching and profit-sharing program to help you save for your retirement.
Low premium health benefits including medical, dental, and vision coverage to support your well-being and that of your family.
Life insurance and disability coverage to ensure financial security for you and your dependents.
An array of optional benefit plans such as accident insurance and specified disease coverage to protect you from the unexpected.
Full tuition reimbursement (up to the IRS limit) for approved courses and programs that support continuous learning.
A best-in-class employee Well-Being program to support all dimensions of your health and wellness.

MVP Health Care analyzes the latest market data to determine employee compensation. Compensation figures listed in a job posting are subject to change as new market data becomes available. The salary range, other compensation, and benefits information is accurate as of the date of this posting. MVP Health Care reserves the right to modify this information at any time, subject to applicable law.

More detailed information about total compensation and benefits will be provided during the hiring process.

At MVP, we are committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. Specific employment offers and associated compensation will be made individually based on several factors , including but not limited to geographic location ; relevant experience, education, and training; and the nature of and demand for the role.

In addition, we offer a comprehensive benefits package that includes:

Considerable paid time away from work including PTO (Paid Time Off), s ick t ime, service t ime o ff, p aid h olidays, and f loating h olidays , allowing you to take time off when it suits you best.
Competitive 401(k) employer matching and profit-sharing program to help you save for your retirement.
Low premium health benefits including medical, dental, and vision coverage to support your well-being and that of your family.
Life insurance and disability coverage to ensure financial security for you and your dependents.
An array of optional benefit plans such as accident insurance and specified disease coverage to protect you from the unexpected.
Full tuition reimbursement (up to the IRS limit) for approved courses and programs that support continuous learning.
A best-in-class employee Well-Being program to support all dimensions of your health and wellness.

MVP Health Care analyzes the latest market data to determine employee compensation. Compensation figures listed in a job posting are subject to change as new market data becomes available. The salary range, other compensation, and benefits information is accurate as of the date of this posting. MVP Health Care reserves the right to modify this information at any time, subject to applicable law. More detailed information about total compensation and benefits will be provided during the hiring process.

MVP Health Care is an Affirmative Action/ Equal Employment Opportunity (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), and the Know your Rights protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com

Please apply and learn more - including how you may become a proud member of our team.

Other details

Job Family Claims/Operations
Pay Type Salary
Min Hiring Rate $44,850.00
Max Hiring Rate $81,717.00