Senior Data Submissions Operations Associate

🔥 12 hours ago

🇺🇸 United States – Remote

💵 $55k - $90k / year

⏰ Full Time

🟠 Senior

⚙️ Operations

👻 Ghost score 0%

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Devoted Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2017

🏥 Healthcare

⚕️ Healthcare Insurance

🧘 Wellness

Healthcare • Healthcare Insurance • Wellness

Devoted Health is a healthcare company that offers Medicare Advantage plans designed to provide comprehensive health coverage with added benefits like dental, eyewear, gym memberships, and prescription drugs at competitive rates. The company emphasizes member support and service, ensuring that clients can easily navigate their benefits and access needed healthcare services. Devoted Health is committed to helping customers save money and enhance their health and wellness through a complete package of benefits and support.

📋 Description

• Own the end-to-end audit file submission process, including file validation, coversheet completion, and final upload via CMS portal • Coordinate and direct day-to-day work activities of assigned team members for submission-related tasks, ensuring priorities, timelines, and quality standards are met • Partner with Devoted’s internal management team to align assignments and resolve resource issues • Conduct detailed quality assurance checks on all files against CMS specifications, including naming conventions, file size limits, date visibility, provider credentials, and document legibility • Monitor and triage submission feedback, routing issues to coding, file prep, compliance, or audit teams • Maintain tracking of submission status, metadata, and resolution notes in internal audit logs • Partner with internal Tech and IT Submission teams to resolve system issues, optimize processes, and manage secure file transfers • Prepare and deliver submission metrics, error trends, and resolution summaries for RADV operations reporting • Leverage SQL, Looker, or other BI tools to extract and analyze submission data where appropriate • Document and update standard operating procedures for submission, QA, and feedback resolution

🎯 Requirements

• Proven experience in healthcare data submissions, medical record management, or health information operations, ideally in a Medicare Advantage or risk adjustment audit environment • Strong attention to detail with the ability to perform meticulous QA under time-sensitive conditions • Ability to troubleshoot technical submission errors and partner effectively with IT and technical teams • Strong organizational skills and experience managing high-volume workflows with compressed timelines • Experience collaborating with offshore resources or distributed teams, with the ability to clearly communicate priorities and task requirements without direct managerial authority • Excellent communication and collaboration skills for working with cross-functional teams • Bachelor’s degree in Healthcare Administration, Health Information Management (HIM), Business, or related field is desired; relevant professional experience will be considered in lieu of a bachelor's degree • Proficiency with SQL, Looker, or other BI/database query tools for analyzing and validating submission data is a huge plus • 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