Supervisor, Encounter Data Management

Job description

Accountabilities: Oversee business processes supporting the successful submission and reconciliation of Medicaid and Medicare encounter data, ensuring submissions meet applicable compliance and quality standards. Analyze encounter and claims data to identify errors, trends, root causes, and opportunities to improve acceptance rates and operational performance. Develop and enhance tools, reporting, and processes that improve the quality, accuracy, and efficiency of encounter submissions. Supervise support and technical associates, providing day-to-day direction, coaching, guidance, and performance oversight. Ensure consistent execution of established processes and policies across the team while maintaining accountability for quality and compliance. Manage schedules, operational plans, daily priorities, and workflow decisions to support business objectives. Investigate and resolve escalated and complex issues, coordinating with relevant teams to identify effective and sustainable solutions. Collaborate with multiple departments and stakeholders to improve encounter data processes and address operational challenges. Prepare and deliver presentations, findings, and recommendations to senior leadership. Identify opportunities for long-term process enhancements and contribute to initiatives focused on operational excellence and continuous improvement. Requirements: At least 2 years of experience in Medicare and/or Medicaid claims processing, including experience handling internal and external claim-processing errors. At least 2 years of formal or informal leadership experience, with a demonstrated ability to provide direction, guidance, coaching, and oversight. At least 1 year of experience working with CAS, Edifecs, Optum, or similar DOS 835/837 warehouse systems. At least 2 years of advanced Microsoft Excel experience, including VLOOKUPs, pivot tables, and the ability to create macros. At least 1 year of SQL experience, including the ability to run queries and use data to support operational analysis. Strong analytical and problem-solving skills, with the ability to identify trends, investigate complex issues, and translate findings into practical recommendations. Strong communication and presentation skills, including the ability to communicate effectively with senior leadership and cross-functional stakeholders. Demonstrated ability to collaborate across multiple departments and build productive working relationships. A bachelor’s degree is preferred, particularly in a relevant business, healthcare, analytics, or technical discipline. Experience specifically focused on encounter submissions is preferred. Six Sigma or Project Management certification is a plus. Prior experience in healthcare or insurance environments is preferred. For remote work, candidates must have a dedicated workspace that protects confidential member and healthcare information and an internet connection capable of at least 25 Mbps download and 10 Mbps upload speeds. Occasional travel to company offices for training or meetings may be required. Benefits: Salary: $65,000–$88,600 per year, with actual compensation varying based on location, experience, skills, education, certifications, and other relevant factors. Bonus opportunity: Eligibility for a bonus incentive plan based on individual and/or organizational performance. Work arrangement: Fully remote position with nationwide availability. Healthcare: Medical, dental, and vision coverage supporting employees and their families. Retirement: 401(k) retirement savings plan. Paid time off: Paid time off, company holidays, and personal holidays. Family support: Paid parental and caregiver leave. Protection benefits: Short-term and long-term disability coverage and life insurance. Well-being: Additional programs and resources designed to support personal wellness and informed healthcare decisions. Schedule: Full-time position with a standard 40-hour workweek. How Jobgether works: We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team. We appreciate your interest and wish you the best! Why Apply Through Jobgether? Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time. #LI-CL1 This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Supervisor, Encounter Data Management based in United States. This is a remote leadership opportunity focused on improving the accuracy, compliance, and efficiency of healthcare encounter data submissions.You will oversee processes supporting successful Medicaid and Medicare encounter submissions and reconciliation.The role combines operational leadership, data analysis, technical problem-solving, and continuous process improvement.You will lead a team of support and technical associates while coordinating with multiple internal departments.Your work will directly contribute to higher encounter acceptance rates and stronger regulatory compliance.You will also handle complex escalations, present insights to senior leadership, and identify opportunities for long-term process improvements.This position is well suited to a collaborative healthcare data professional who enjoys combining hands-on analytics with team leadership.