Job Description :
Direct End Client: State of MD
Job Title: Research Analyst
Duration: 36 Months
Start Date: July 1, 2018
Location: 750 East Pratt Street, 6th Floor, Baltimore, MD 21202
Position Type: Contract
Interview Type: Phone/ Skype/ In-person
Requirement ID: SMD_EDI218_SS
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 Children’s Health Insurance Program (MCHP
Responsibilities:
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 daily.
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.
Required Skills:
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 Skills:
A minimum two (2) years of experience supporting MMIS and/or HBX applications.
Knowledge of the Affordable Care Act (ACA)
.
V Group Inc. is an IT Services company which supplies IT staffing, project management, and delivery services in software, network, help desk and all IT areas. Our primary focus is the public sector including state and federal contracts. We have multiple awards/contracts with the following states: AR, CA, DE, FL, GA, IL, KY, MD, ME, MI, NC, NJ, NY, OH, OR, PA, SC, TX, VA, and WA. If you are considering applying for a position with V Group, or in partnering with us on a position, please feel free to contact me for any questions you may have regarding our services and the advantages we can offer you as a consultant. Please share my contact information with others working in Information Technology.
Please share my contact information with others working in Information Technology.
Website:
Twitter:
Facebook: