What are the responsibilities and job description for the Capitation Revenue Analyst position at MedPOINT Management?
Job Description
Job Description
The Capitation Revenue Analyst must be a critical thinker and will support the Finance team in a variety of activities, including assurance of data integrity relating to the planning and execution of departmental and organizational goals as needed. Under the general guidance of the Lead Revenue Data Analyst, the Capitation Revenue Analyst shall assist in data research, data gathering, and data analysis for all initiatives. The Analyst will develop, provide data quality assurance, identify existing data issues, and key drivers to aid in the development of solutions.
Responsibilities
- Synthesizes large data sets to support the development and maintenance of operational performance reports, and submission of regulatory reporting efforts.
- Evaluates data gathered from multiple sources to support the issues, conclusions and recommendations.
- Analyzes data with standard methods, interprets the results, and provides written summary and reporting of analysis.
- Coordinates preparation and analysis of internal and external reports through gathering, analyzing and summarizing data and information.
- Develops and validates queries through SQL for the successful extraction of appropriate data.
- Ensures accuracy to maintain the high quality and integrity of information, data and databases.
- Prepare and deliver departmental and client reporting utilizing multiple systems and databases.
- Create and update various report formats to prepare for import into SQL server
- Validate and track documents are received timely and prepare import data from various file types (Text, Excel, Access, etc.) to SQL server via SSMS
- Troubleshoot data integrity for SSIS data import process
- Gather revenue data monthly from various data sources
- Validate and Identify anomalies in the source reports and imported data in SQL server
- Import data from SQL server into and export data from MS Access or Excel to create reports
- Create queries in MS Access to process data
- Assist Financial Analysts to update queries, identify data anomalies, and troubleshoot in MS Access and Excel
- Create desired dataset by joining data from different sources in SQL server
- Assist with design of workflow tools, develops and maintain documentations and libraries on key processes.
- Create ad hoc reporting and queries as needed to respond to management inquiries.
- Examine, assess, and document business operations and procedures to ensure data integrity and process optimization.
- Prepare weekly, monthly and quarterly reports as needed by management
- Prepare SSIS packages for Capitation Revenue loading
- Use Visual Studio to load prepped Capitation Revenue files and RA Validation sheets, while verifying the integrity of the data
- Troubleshoot files that are showing errors while trying to process
- Assemble spreadsheet, charts and graphs to provide financial support and analysis
- Extensive research to determine accuracy of database entries to help implement business controls for current and future processes
- Prepare summaries and reports to track and measure productivity throughout the month
- Use pertinent data and facts to identify and solve a range of problems within area of expertise
- Structure and prepare analysis to support decision making
- Process Health Plan capitation revenue through sql or successor data warehousing, work with senior analyst in development and launch of various tracking and recovery reports as assigned
- Serves as a resource to others
- Communicate and coordinate with Health Plans to ensure complete documents are received that supports payments received
- Prepare Health Plan reports to support monthly and quarterly underpayment reconciliation with the health plan
- Communicate with the Health Plan to provide clarifying answers to their inquiries
- Other projects as assigned by management
- Assist in reports needed for quarterly PCP profitability
- Process our quarterly Eligibility to Cap Revenue reports.
- Communicate with Health Plans regarding discrepancies in our Eligibility to Capitation reports
Minimum and Preferred Qualifications :
Typical education and experience required and preferred, including licensing requirements, special training and certifications.
Experience : 3 to 5 years in a health plan environment
Education : Bachelor’s degree in CIS / MIS field or equivalent combination of education and experience.
License / Certification / Special Training : SQL, SSIS, Microsoft Suite with focus on Access and Excel, PowerBi
Skills / Abilities :
