Senior Data Submissions Operations Associate

This is a fully remote position, open to applicants in United States.

📋 Description

• Take ownership of the complete audit file submission process, which encompasses file validation, coversheet completion, and final upload through the CMS portal.

• Oversee and guide the daily activities of team members assigned to submission-related tasks, ensuring that priorities, timelines, and quality standards are maintained.

• Collaborate with Devoted’s internal management team to synchronize assignments and address resource challenges.

• Perform thorough quality assurance checks on all files in accordance with CMS specifications, including naming conventions, file size restrictions, date visibility, provider credentials, and document clarity.

• Monitor and manage submission feedback, directing issues to coding, file preparation, compliance, or audit teams as necessary.

• Keep track of submission status, metadata, and resolution notes in internal audit logs.

• Work alongside internal Tech and IT Submission teams to troubleshoot system issues, enhance processes, and manage secure file transfers.

• Prepare and present submission metrics, error trends, and resolution summaries for RADV operations reporting.

• Utilize SQL, Looker, or other BI tools to extract and analyze submission data when appropriate.

• Document and revise standard operating procedures for submission, quality assurance, and feedback resolution.

⛳️ Requirements

• Demonstrated experience in healthcare data submissions, medical record management, or health information operations, preferably in a Medicare Advantage or risk adjustment audit setting.

• Exceptional attention to detail with the capability to conduct thorough quality assurance under tight deadlines.

• Proficient in troubleshooting technical submission errors and collaborating effectively with IT and technical teams.

• Strong organizational abilities and experience managing high-volume workflows within compressed timelines.

• Experience in collaborating with offshore resources or distributed teams, with the ability to clearly communicate priorities and task requirements without direct managerial authority.

• Excellent communication and teamwork skills for effective interaction with cross-functional teams.

• A Bachelor’s degree in Healthcare Administration, Health Information Management (HIM), Business, or a related field is preferred; relevant professional experience will be accepted in lieu of a bachelor's degree.

• Proficiency in SQL, Looker, or other BI/database query tools for analyzing and validating submission data is a significant advantage.

• Experience working with CMS systems such as the Central Data Abstraction Tool (CDAT), Encounter Data Processing System (EDPS), or similar healthcare submission portals.

• Familiarity with ICD-10 coding or risk adjustment data.

🏝️ Benefits

• Employer-sponsored health, dental, and vision plan with low or no premium.

• Generous paid time off.

• $100 monthly mobile or internet stipend.

• Stock options for all employees.

• Bonus eligibility for all roles excluding Director and above.

• Parental leave program.

• 401K program.