Business Analyst - Psychiatry Administration

Medical University of South Carolina•Charleston, SC

3d•Onsite

About The Position

The Business Analyst is responsible for reviewing medical records to ensure accuracy, completeness, and compliance with regulatory and organizational standards. This role focuses on evaluating treatment plans and 90-day summaries to confirm appropriate documentation, quality of care, and adherence with the applicable guidelines of the South Carolina Department of Health and Human Services (SCDHHS) Community Mental Health Rehab Contract.

Requirements

Bachelors Degree or equivalent Work Experience
5 years for support or 0-2 years for professional
Must be able to act independently in the furtherance of compliance objectives following MUSCP Compliance Department and organizational established policies and procedures.
Must be able to identify and respond to escalated problems or questions in a timely fashion.

Nice To Haves

Experience educating physicians in group or individual sessions.
Demonstrates solid technical knowledge, understanding of business concepts, regulatory rules, and auditing procedures.
Experience researching questions and providing documentation to support decisions regarding the Medicaid Rehab Contract.
Excellent communication and interpersonal skills.
Knowledge of Microsoft Office Applications including Word, Excel, and PowerPoint.
Experience with and aptitude for using medical billing software.

Responsibilities

Evaluate treatment plans to ensure they are properly completed, documented, and signed by an MD or APP. Ensure these are completed yearly for every Medicaid patient.
Analyze all Medicaid patient charts to ensure 90-day summaries to verify timely completion, accuracy, and alignment with patient care goals. These must be completed within 90 days of admission to an outpatient psychiatric clinic and for individuals that have not been seen in 6 months.
Review medical records for completeness, accuracy, and compliance with state (SCDHHS) and organizational regulations.
Complete daily audits following all MUSCP Compliance procedures and report monthly findings to Director of Practice, Department Administrator, Chairman or other leaders as directed on a monthly basis.
Act as the Data Manager to track and report audit findings, trends, and areas of risk to leadership and the individual providers. Develop the methodology for audits and reports to present findings in a clear concise manner. Responsible for follow up audits to validate resolution of documentation issues and completion of corrective action plans.
Assist in the development and deployment of educational/training materials and campaigns; communicates proactively extensively throughout the system to provide education on compliance matters related to the South Carolina Department of Health and Human Services (SCDHHS) Community Mental Health Rehab Contract.
Identify documentation gaps, inconsistencies, or potential compliance risks.
Provide feedback and recommendations to clinical staff to improve documentation quality.
Responsible for entering all education sessions into designated system per departmental instructions.
Performs other duties as assigned.