Encounter Data Management Professional in United States at Jobgether

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Encounter Data Management Professional in the United States.

This role plays a key part in ensuring the accuracy, integrity, and compliance of healthcare encounter data used in Medicaid and Medicare programs. You will be responsible for identifying and resolving claims and submission errors while supporting end-to-end encounter data processes. The position requires strong analytical thinking and the ability to independently assess data issues and determine appropriate resolutions. You will contribute to the development and optimization of business processes that improve submission quality and acceptance rates. Working in a fast-paced, highly regulated environment, you will help ensure regulatory standards are consistently met. The role also involves cross-functional collaboration with internal teams to support continuous improvement initiatives. It is ideal for someone detail-oriented, process-driven, and motivated by data accuracy in healthcare operations.

• Ensure the accuracy and integrity of encounter data by identifying, investigating, and resolving claims and submission errors across Medicaid and Medicare systems.
• Support end-to-end encounter submission and reconciliation processes, ensuring compliance with all regulatory and organizational standards.
• Analyze data issues and perform root cause analysis to identify trends and implement long-term process improvements.
• Develop, document, and enhance business processes and tools that improve submission quality and acceptance rates.
• Collaborate with internal stakeholders to support reporting, operational alignment, and continuous improvement initiatives.
• Follow established procedures while applying independent judgment to resolve moderately complex data and process issues.

• 1–5+ years of experience in claims processing or healthcare data operations.
• At least 1 year of experience in root cause analysis, issue resolution, and process improvement.
• Strong ability to document workflows, procedures, and operational processes clearly for future reference.
• Familiarity with Medicaid/Medicare or healthcare insurance environments is strongly preferred.
• Exposure to X12 transactions and healthcare data formats is a plus.
• Experience with Microsoft SQL or SAS is highly desirable.
• Strong analytical, problem-solving, and communication skills with attention to detail and accuracy.
• Ability to work independently in a fast-paced, compliance-driven environment.

• Competitive annual salary range of $65,000–$88,600 with potential bonus eligibility based on performance.
• Comprehensive healthcare coverage including medical, dental, and vision insurance.
• 401(k) retirement savings plan with employer support.
• Paid time off, company holidays, parental leave, and caregiver leave.
• Short-term and long-term disability coverage, life insurance, and wellness-focused programs.
• Flexible remote work arrangement with required home office setup support (high-speed internet and dedicated workspace).
• Access to professional development opportunities and career growth within a healthcare-focused organization.