Claiming Analyst - Revenue Cycle Management

Sycamores•Los Angeles, CA

7d•$23 - $26

About The Position

Sycamores provides a spectrum of equitable mental health services through various programs to multicultural populations of all acuities. Although it serves a variety of consumers, the agency focuses primarily on providing care to low-income, high at- risk youth. The role of the Claiming Analyst is to maintain electronic claiming functionalities within the Electronic Health Record System (EHRS). The maintenance of the claiming functionalities within the Electronic Health Record System will include but is not limited to working denials, processing voids and claims.

Requirements

High school diploma or equivalent; associate or bachelor’s degree preferred.
Minimum of 1-2 years’ experience in QA/QI related activities or mental/managed care billing preferred.
Experience in data entry, billing, or administrative work required.
Familiarity with the LA County IBHIS system is a plus.
Basic math skills.
Ability to accurately enter detailed accounting data on the computer.
Intermediate level knowledge of Microsoft Excel and Outlook programs.
All candidates who are presented with a conditional offer of employment must satisfy a pre-employment background check, drug and health screen.

Nice To Haves

associate or bachelor’s degree
1-2 years’ experience in QA/QI related activities or mental/managed care billing
Familiarity with the LA County IBHIS system

Responsibilities

Use internal communication to track admissions across all programs, in order to accurately create and open consumers financial profile in both EHRS and IBHIS.
In collaboration with eligibility worker, research and resolve consumer eligibility issues.
Responsible for weekly submission of EDI claims to LACDMH, including voids and resubmissions. It is the responsibility of the Analyst to ensure all claims have completed all steps in the Revenue Cycle.
In collaboration with Claiming and Revenue Manager, claim, track and monitor invoice/EDI claims to other funding entities to ensure timely submission.
Verifies that batches have been submitted properly by performing reconciliation to identify any discrepancies that may have occurred within the batch.
Monitor, analyze, correct and resubmit claims to LACDMH in a prompt and accurate manner.
Maintain proficiency in Sycamores EHR system and DMH IBHIS and affiliate systems to process external claims.
Responsible for responding to claiming inquiries, such as progress note corrections, funding issues and program changes.
Maintain the highest level of customer service when responding and collaborating with internal and external consumers.
Process LACDMH C# applications in order to grant or renew staffs access to DMH forms.
Performs other related duties as assigned.