Allscripts

Sr. Systems Analyst

Job Locations US-MD-Annapolis | US-IL-Chicago | US-NC-Raleigh | US-GA-Atlanta | US-MA-Boston | US-MN-Minneapolis | US-TX-Dallas
Requisition ID
2020-25482
Posted Date
2 weeks ago(11/9/2020 8:00 AM)
Category
Other

Overview

Pulse8

 

 

About Pulse8, Inc.

Pulse8 is an innovative Healthcare Analytics and Technology Company that delivers visibility and transparency for Risk Adjustment and Quality Management programs.  We enable health plans and at-risk providers to achieve the greatest financial impact in the Health Insurance Exchange (HIX), Medicare Advantage, and Medicaid markets.  By combining advanced analytic methodologies with extensive health plan experience, Pulse8 has developed a suite of uniquely pragmatic solutions that are revolutionizing risk adjustment.  Pulse8’s flexible business intelligence tools offer real-time visibility into member and provider activities so our clients can apply the most cost-effective and appropriate interventions for closing gaps in documentation, coding, and quality. 


What's cool about working for Pulse8?
We're a close-knit team of Healthcare and Technology experts dedicated to helping people live longer, healthier lives.  You'll get to help us design and build innovative solutions from the ground up and have the opportunity to do lots of interesting things in an entrepreneurial culture.  We offer competitive benefits and much, much more! 

 

Position Description

The Product Support specialist works primarily with enterprise customers of Pulse8’s Encounter Management Platform, proactively assisting them with post- sales installation, configuration, upgrade, troubleshooting and day to day operational management. Responsibilities include taking a proactive leadership role working with the Engineering team and Customers to triage and resolve highly complex, technical, and application-related issues which impact product performance in customer-specific environments, or issues that directly hamper a broader customer adoption of Pulse8’s Encounter Management Platform. In addition to working with customers, the Product Support Specialist will routinely partner with our Development, Sustaining Engineering and Sales Engineering organizations to resolve support issues, document bugs, provide UAT on product builds, and ensure that new and newly upgraded server installations are successful.

 

This is a remote role.

Responsibilities

  

  • Support encounter data reporting processes for EDPS, RAPS and the EDGE server, including tracking, reporting, and resolving rejections
  • Conduct gap analysis and data validation, identifying possible issues in data submission and determining financial impact.
  • Analyze and reconcile claims and encounter data which will include 837 EDI encounter files for EDPS, RAPS and Edge Server submission files
  • Perform research in the encounter management system and liaison with the CSSC Helpdesk for exception resolution
  • Be comfortable with raw data files in their native format and accessing these through various servers
  • Provide technical support to enterprise clients related to technical and operational aspects of the products
  • Partner with Product Support Engineers and development teams as necessary
  • Assist development team with performance analysis and testing during release cycles for service packs, hot fixes etc.
  • Answer email and phone requests for help from customers
  • Collaborate in virtual teamwork with other Product Support staff
  • Host online troubleshooting and investigation sessions on customer’s production environments
  • Deliver a consistent, responsive and satisfying customer experience with each contact
  • Collect all necessary problem details from customers to be able to effectively see the problem to resolution
  • Successfully reproduce customer issues in a controlled test environment
  • Follow standard operational procedures for case management
  • Continuously improve troubleshooting skills, product expertise, and knowledge on related technical topics
  • Update knowledge base / create reusable documents, originating from patterns observed during customer issue troubleshooting
  • Perform ACA and MA Submissions for Clients
  • Understand and keep track of CMS model changes which details about eligible Risk Adjustment codes (diagnosis, CPT, HCPCS, etc.,) for submissions.
  • Review and understand periodic CMS software releases which impact both the ACA and MA submissions.
  • Understand RAPS and EDPS filtering logic which CMS uses for Risk Adjustment and/or Risk Score calculations.
  • Monitor CMS data submission deadlines for both MA and ACA lines of business.

Qualifications

Academic and Professional Qualifications:

  • Bachelor’s Degree in Health IT/Informatics/Management Information Systems or related field required

 

Experience:

  • 3+ years of professional experience in Risk Adjustment data management
  • Understanding of claims data, encounter response files, 837 EDI encounter files, EDGE/MA billing & business rules as well as MA filtering logic for RAPS/EDPS
  • Experience with CMS Submissions Process and EDI transactions
  • Excellent time management and organizational skills necessary
  • Prior experience troubleshooting performance problems that may have many underlying causes such as Disk, Database, Network, Messaging and other platform / 3rd party solutions.
  • Experience with managing product back end and webservices
  • Ability to guide customers remotely through complex, multi-server deployments and upgrades for enterprise products
  • Familiarity with at least one non-Windows operating system (such as Linux, HPUX, AIX)
  • Familiarity with EDI Standards such as X12, EDIFACT, HL7, NCPDP and knowledge of HIPAA transactions.
  • Knowledge of various network and internet technologies and communication protocols: TCP/IP, SFTP, HTTP, AS2, etc. highly desired. 
  • Prior knowledge of 837’s along with various loops and segments and an understanding of the requirements set forth by CMS for EDPS submission files
  • Prior experience with ETL and Mapping
  • Excellent working knowledge of SQL
  • Very strong written and verbal skills.
  • Knowledge in CMS model changes is a plus
  • Knowledge in CMS Risk Score and Risk Adjustment methodologies is a plus

 

Travel Requirements:

  • Will travel to Annapolis, MD for new hire orientation and then all Pulse 8 employees attend two company summits per year in various locations.

 

 Working Arrangements:

  • Monday through Friday or as defined by assignment requirements

 

Pulse8 is a stand-alone brand, fully owned by Allscripts, with its own C-level and senior leadership. When you work for Pulse8, you get the advantages and benefits of working with a large, public company with the innovative culture and direction and of a small, nimble company.

 

At Allscripts, our greatest strength comes from bringing together talented people with diverse perspectives to support the technology needs of 180,000 physicians, 1,500 hospitals and 10,000 post-acute organizations across the globe. Allscripts offers a comprehensive compensation and benefits package, including holidays, vacation, medical, dental, and vision insurance, company paid life insurance and retirement savings.

 

Allscripts' policy is to provide equal employment opportunity and affirmative action in all of its employment practices without regard to race, color, religion, sex, national origin, ancestry, marital status, protected veteran status, age, individuals with disabilities, sexual orientation or gender identity or expression or any other legally protected category. Applicants for North American based positions with Allscripts must be legally authorized to work in the United States or Canada. Verification of employment eligibility will be required as a condition of hire.

 

#LI-ALL

 

From a "VEVRAA Federal Contractor" We request Priority Referral of Protected Veterans

This is an official Allscripts Job posting.  To avoid identity theft, please only consider applying to jobs posted on our official corporate site.

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