Claims Data Steward (Remote)


Job Details

Our History:
From our start in 2009, Conexess has established itself in 3 markets, employing nearly 200+ individuals nation-wide. Operating in over 15 states, our client base ranges from Fortune 500/1000 companies to mid-small range companies. For the majority of the mid-small range companies, we are exclusively used due to our outstanding staffing track record.

Who We Are:
Conexess is a full-service staffing firm offering contract, contract-to hire, and direct placements. We have a wide range of recruiting capabilities extending from help desk technicians to CIOs. We are also capable of offering project-based work.

Conexess Group is aiding a large healthcare client in their search for a Claims Data Steward in a remote capacity. This is a long-term opportunity with a competitive compensation package.


Responsibilities:

  • Serves as Data Steward dedicated to health care payer Claims data operations & initiatives
  • Works collaboratively with other enterprise and business data stewards to align standards and share best practices; represents Claims data domain in enterprise workgroups and data steward communities of practice
  • Leads Data Governance initiatives and collaborations with business and IT operational stakeholders to:
    Document, define, maintain, and manage data standards and assets, e.g., Critical Data Elements (CDEs), business terms, definitions, reference data, and business rules
    Ensure the implementation of the data governance program, tools, best practices and compliance with data standards
  • Assesses and monitors data quality metrics, analyzes trends, and proactively promotes remediation and preventive action efforts
  • In conjunction with the business owners:
    Defines and communicates metrics to gauge the health and quality of data across enterprise systems
    Identifies and presents recommendations on business process improvements and efficiencies, including business case and implementation options
  • Provides consultative stewardship services to delivery and issue resolution teams, as needed, to ensure efficient and accurate flow of data.
Qualifications:
  • Bachelor s Degree
  • Intermediate to Advanced skills in data analysis and data governance tools (e.g., SQL, SAS, TOAD, Python, Hadoop, Teradata, Snowflake, Tableau, Collibra, Infosphere, Alation, etc.)
  • Project management and Six Sigma skills are a plus
  • Experience in Agile Methodology and tools (e.g., Jira, Rally, etc.)
  • 5+ years professional work experience in: Data Governance, Data Management and Data Quality practices
  • Healthcare payer data products and processes
  • Claims data standards and operations, including: In depth subject matter knowledge of health care claim / encounter terminology, concepts and business processes within one or more data subdomains, e.g., medical, behavioral, vision, dental, pharmacy, etc.
  • Health care data claim / encounter transactions systems, e.g., Proclaim, Facets, EDI Gateway 837, HL7, FHIR, Arcadia or other claim / electronic medical record (EMR) data sources and data repositories
  • Claim / encounter end-to-end lifecycle processes, e.g., submission, processing, payment, reconciliation, etc.
  • Claim / encounter reference data standards, groupers and classifications, e.g., ICD-10, CPT, HCPCS, DRG, APC, ASC, SNOMED CT, EDI implementation guides, etc.
  • Strong communications skills (verbal, listening, written, and presentation) with management teams and peer groups
  • Strong leadership skills to motivate others to achieve goals and inspire change; ability to engage business and data stakeholders to resolve questions or issues; demonstrate ability to create professional relationships and effectively influence cross-functional teams
  • Must have the ability to handle multiple and sometimes competing priorities in a fast-paced environment; ability to organize and develop project plans supporting near and long-range goals and actions; able to strategize across complex, cross-functional projects and initiatives
  • Must have strong analytical and problem-solving capabilities
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 Conexess Group, Llc

 05/18/2024

 Denver,CO