At WelbeHealth, we serve our communities' most vulnerable seniors through shared intention, pioneering spirit, and the courage to love. These core values and our participant-focus lead the way no matter what.
The Encounter Data Specialist is a key member of the WelbeHealth configuration team, accountable for supporting and ensuring the successful and compliant submission of encounter data reporting to both CMS (federal) and state agencies.
This role plays a critical role in ensuring accurate and compliant encounter data submissions, directly supporting organizational compliance, reporting integrity, and operational success within a highly regulated healthcare environment. Partners cross-functionally with internal teams and external vendors to investigate encounter submission issues, identify root causes, resolve data discrepancies, and support scalable encounter reporting processes as WelbeHealth continues to grow.
Responsibilities include ensuring encounter data submissions meet federal and state requirements; analyzing and interpreting encounter data errors to identify potential issues and trends; reviewing and resolving encounter errors in a timely manner to maintain high encounter submission acceptance rates; monitoring monthly federal and state encounter data reports and creating error resolution plans; staying informed of federal and state updates for encounter data rules and regulations; working closely with both internal and external partners to identify issues and perform root cause analyses on encounter rejections related to claims data and eligibility; supporting new implementations of encounter submissions to CMS and state agencies necessary for company growth.
The role requires a detail-oriented, analytical, and collaborative individual with a strong understanding of encounter data processes, claims operations, and regulatory requirements.
High school diploma or equivalent. Minimum of three (3) years of experience with encounter data submissions and resolution; five (5) years as a healthcare claims supervisor or above may be substituted. Excellent organizational, time management, and communication skills. Proficient with Microsoft Office, including Excel. Ability to work independently with minimal supervision. Demonstrated ability to prioritize in a fast-paced environment.
Medical insurance coverage (Medical, Dental, Vision). 17 days of personal time off (PTO), 12 holidays observed annually, and 6 sick days. 401K savings + match. Comprehensive compensation including base pay and bonus. Commitment to diversity, equity, and inclusion. COVID-19 vaccination policy and infection control standards.
Location
Los Angeles, California, US
Employment Type
Full-time
Experience Level
Associate
Salary Range
$61,663 - $81,395
Remote work allowed
No
Posted
1 week ago