Data Quality Analyst (000094)

Job Description

Job Description

Duties:
The Test and Trace Corps is looking for a Data Quality Analyst to join the Data, Analytics and Product Development Team, dedicated to organizing, analyzing, and communicating data as well as building technology solutions, in order to support and inform programmatic and operational efforts of the initiative

Summary Of Duties And Responsibilities:
Reporting to the Data Quality Unit Director in the Data, Analytics and Product Development Team, the Data Quality Analyst will be responsible for: Ensuring standard handling and representation of data and assisting in development of processes and coding to classify and standardize data for meaningful use/analyses to advance the programmatic effectiveness of Test and Trace Corps initiatives
Validating data for completeness and accuracy based on guidelines set by pillar stakeholders or data management systems including working with data providers to improve data management workflow
Collaborating with data staff and other departments within the Data, Analytics and Product Development Team to identify and mitigate potential data issues
Regulating and assisting with advising protocols and processes to uphold the cleanliness of data produced by data managers, data scientists, and data analysts
Cleaning large datasets as needed in a timely and thorough manner Auditing and reporting the quality control (QC) of data analysis and visualizations that are generated for Test and Trace Corps functions and needs
This is the pay range that reasonably expects to pay someone for this position, however, as a supplier your expected pay range may vary and/or include certain benefits like: Medical, Dental, Vision, 401K [include any compulsory benefits such as commissions, incentive bonuses, etc. if applicable].

Skills:
Computer programs/software operated:
General knowledge of SQL, R, Python, Excel and related data analytics toolsets Preferred Skills:
Ability to work autonomously, think analytically, and anticipate data issues to solve before they arise
Excellent written and verbal communication skills, with the ability to explain data systems to non-technical teams
Strong quality control abilities and exceptional attention to detail

Education:
Qualifications for the Job: Certification(s)/ Nys License(s):
Residency preferred educational level:
A Masters degree in Public or Business Administration or in an equivalent or equally acceptable program and four (4) years of experience in a major governmental agency or large corporation or foundation in management analysis or in operational direction, planning, coordination or control of which, two years must have been in a supervisory, administrative or consultative capacity or
Bachelors degree from accredited college or university and five (5) years of experience as described above, of which three (3) years must have been in a supervisory, administrative or consultative capacity; or
A satisfactory equivalent combination of training, education and/or experience.

Languages:
English: Read, Write, Speak

Skills:
Required
Metro Plus Claims Processing Guidelines and Benefit Structures, High Volume Inquiries, Metro Plus Claims Processing, IMAX and TXEN Systems, Claim Adjuster

Additional
Strong Customer Service Skills, Problem Solving and Follow Up Management Skills, Issue Resolution

Schedule Notes:
Candidate requirements: Work Schedule: Full time Hours Per Week: 35 Days: Monday, Tuesday, Wednesday, Thursday, Friday Shift time: 9am - 5pm Work location: Hybrid Patient Facing: No Position Overview: This position is responsible for the accurate and timely response to written claim inquiries received from providers. Incumbent provides support regarding the adjudication and adjustment of claims for the multiple lines of business. The incumbent works closely with Provider Relations, Medical Management, Member Services and the Claims Processing unit Scope of Role & Responsibilities: Act as a key liaison and service representative for all written provider inquiries and problem resolution.
Respond to all claim inquiries from provider sites personnel including physicians, clinical staff, and site administrators.
Coordinate and track appropriate problem resolution activities with plan personnel in other departments (i.e., claims, utilization management)
Manage and ensure appropriate follow-up and closure for all inquiries
Respond to Provider Inquiries in writing; maintain accurate files
Data Entry into the IMAX system.
Perform claim adjustments to correct erroneous payments (overpayments/underpayments).
Participate in Special Projects involving Claim Status Investigations.
Resolve Member Bills referred from Member Services.

Required Education, Training & Professional Experience:
In-depth knowledge of MetroPlus Claims Processing protocols and payment schemes.
Thorough knowledge of Plan Benefits.
Proficiency in IMAX and TXEN.
Customer Service Experience a plus.
Must be able to handle irate providers in a professional manner.
Excellent written/verbal communication skills.