Analyst I, Professional Billing & Claims

Community Care Cooperative•Boston, MA

56d•Hybrid

About The Position

The Professional Billing Claims Analyst II position will be housed under a new subsidiary organization of C3, Community Technology Cooperative, LLC (CTC). To implement, maintain, support, and maximize the use of clinical, financial, and administrative portions of the software applications utilized by CTC in conducting daily operations under the direction of the Manager of Professional Billing and Claims. This includes: Maintaining current clinical, financial, and administrative applications, implementing new clinical, financial, and administrative applications Assisting in the assessment of workflow processes and assisting in process re-engineering to achieve efficiencies in departmental operations Assisting users in developing reports and analyses, troubleshooting, and resolution of application issues Working with the IT Education staff to assist in training users and in the development of documentation Maintaining a level of knowledge about IT operations and network issues and maintaining current industry knowledge

Requirements

Ability to understand, analyze, document, and explain business processes and the data that underly them
Experience working with Electronic Health Records, medical claims, and other health care data
Experience working with Clearinghouses to facilitate claims transmission preferred
Flexible and adaptable to change in a fast-paced environment
Demonstrated ability to work both independently and as part of a team
Demonstrated ability to thrive in a fast-past environment
Nuanced interpersonal communication skills
Weekly on-call will be a requirement for this position
Bachelor's degree in a healthcare-related field, Information Systems or Business Management
Resolute Professional Billing Claims Administration and Electronic Remittance certification preferred, but not required
0-1 years of healthcare or Epic experience
Prior EHR support experience preferred, but not required
In compliance with Infection Control practices per Mass.gov recommendations, we require all employees to be vaccinated consistent with applicable law.

Nice To Haves

Familiarity with the MassHealth ACO program
Familiarity with Federally Qualified Health Centers
Experience working in a provider organization
Experience working in a managed care environment
Experience with anti-racism activities, and/or lived experience with racism is highly preferred

Responsibilities

Ability to maintain current system applications
Facilitate end users' ability to understand and maximize the use of the software to perform daily operations
Evaluate user knowledge and work with IT education staff to develop specialized training when necessary; educate users in system optimization
Acts as liaison between users and the software vendor(s)
Guides the modification of system applications in instances where current applications impede performance or where changes will enhance performance
Ensure system application updates are working properly before updates are loaded into the live system by coordinating testing and update dates with users and vendors
Integrate new application(s) in the existing HIS according to the implementation schedule
Respond to user questions with timely answers and/or referral to appropriate department/person
Assist users with technical problems by alerting HIS Operations staff to the need for repair or investigation
Coordinate with Database Analysts to provide expertise in the development of reports and analyses
Work with other IT staff to ensure interfaces between applications and systems are functioning properly
Maintain and periodically review dictionaries, assist in entering and maintaining user codes, maintain the security of applications, and ensure consistency between various dictionaries
Investigate on timely basis discrepancies in statistics which could indicate a problem with the accuracy of data
Work with application managers, staff from affected areas, and representatives from other impacted areas, to analyze computer system functions and compare data and existing systems both functionally and procedurally
Implement new clinical, financial, and administrative software, including add-on features, and/or new routines in existing applications
Participates with other IT staff and other clinical, financial, and administrative areas in the planning and implementation stages of the application, including the development of dictionaries
Work with Department Managers and IT Education staff to ensure training programs for use of applications are developed and conducted for all levels of users and participate in such programs when needed
Develop system documentation to supplement vendor manuals and which defines processes, procedures, and policies regarding utilization of various functions
Assist departments with the development of downtime procedures
Work with Operation Manager and staff to establish schedules for report production and system jobs to maintain balanced system utilization and minimize system degradation, if necessary
Sustain working knowledge of key functions of all aspects of the department in order to provide emergency coverage in the absence of others in the department
Work with Applications Manager to accomplish other departmental tasks
Notify the Applications Manager of requests for custom modifications to standard applications and of any updates to standard systems which replace existing custom modifications so that the Application Manager can take appropriate action
Assist in the development of IT policies and procedures and notify users as appropriate
Participate in applications on-call rotation for the information system
Participate in workgroups and committees as necessary
Demonstrates competent and effective job performance skills as evidenced by the volume, skill, and technical knowledge of work performed, neatness, accuracy, thoroughness, and completeness, and the ability to follow instructions
Strong attention to detail
Ability to manage multiple priorities in an effective and organized manner
Demonstrates the ability to interact effectively and in a professional manner with peers
Administration, and other customers as demonstrated by willingness to work with others to achieve CTC's goals
Ability to present a friendly and positive manner, willingness to seek additional tasks
Responsibility to assist the department and/or peers, ability to be flexible and perform new tasks and adjust to change even under pressure
Ability to accomplish results by working effectively with or through other people
Ability to hear and communicate with others in a clear, understandable, and professional manner in person and on the phone
Ability and commitment to provide outstanding customer service
Ability to actively listen, demonstrate patience and empathy, and authentically engage with individuals in a caring and helpful manner
Ability to identify and resolve problems and maintain composure and sound judgment in difficult or stressful situations
Maintain current industry knowledge by attending industry seminars, reviewing professional literature, and communicating on a regular basis with other IT analysts
Required to travel onsite for site visits and project milestones either at the health center or the CTC office in Boston