Health Care Analyst

State of Connecticut•Hartford, CT

15h•Hybrid

About The Position

The State of Connecticut, Department of Mental Health and Addiction Services (DMHAS) is hiring for a Health Care Analyst. This role is responsible for ensuring Medicare and Medicaid billing is maximized for state-operated facilities and contracted agencies, in accordance with state and federal guidelines. The analyst will research and analyze data, complete claims analysis, and work closely with program and quality staff. Training will be provided to staff of state and private agencies. The position involves preparing data reports, conducting research on billing opportunities, and producing reports for various state and federal agencies. Collaboration with state facilities and private agencies on billing understanding is key. The role also includes tracking Medicare and Medicaid enrollment, ensuring EHR implementation, and working with IT and DAS on system errors and quality testing. DMHAS is a healthcare agency focused on promoting the overall health and wellness of individuals with behavioral health needs through an integrated network of services and supports.

Requirements

Six (6) years of professional experience in financial management with some experience in health care management
Professional accounting or auditing work with responsibility for the review and recommendation of financial policies and procedures of a business organization
College training may be substituted for the General Experience on the basis of fifteen (15) semester hours equalling one-half (1/2) year of experience to a maximum of four (4) years for a Bachelor's degree
A Master's degree in accounting, finance or other closely related field or public health with some college courses in accounting or finance may be substituted for one (1) additional year of the General Experience
Professional experience in health care facility administration, health program administration, health insurance administration, health planning or other health care related fields may be substituted for the General Experience on a year for year basis to a maximum of one (1) year
Successful completion of a Connecticut Careers Trainee program approved by the Department of Administrative Services may be substituted for the General Experience
Knowledge of principles and practices of financial management including organization, administration, management, finance, budgeting, auditing and accounting
Knowledge of health care industry
Interpersonal skills
Oral and written communication skills
Ability in interpretation and analysis of complex financial, statistical and technical data
Ability to utilize computer software

Nice To Haves

Inpatient and Outpatient Behavioral Health billing experience
Experience with Microsoft Access and/or Microsoft Excel software to create analytical reports using database queries
Experience with Microsoft Teams
Experience with Microsoft Excel functions such as formulas, pivot tables, and VLOOKUPs

Responsibilities

Ensure the Medicare and Medicaid billing associated with billable Inpatient and Outpatient services provided by 7 DMHAS state operated facilities and 40+ private non-profit contracted DMHAS agencies is maximized and done in accordance with state and federal guidelines
Research and analyze data that is received from providers and that is released for billing
Analyze reports for further billable opportunities
Complete paid and denied claims analysis through review of Explanation of Benefits
Work closely with program and quality staff who provide and monitor service delivery
Provide training to staff of state agencies and private non-profit agencies
Prepare regular and special project data reports that analyze service delivery, billing and revenue data
Conduct ongoing research of billing opportunities to increase revenue
Produce reports routinely requested by DSS, OPM, state legislature, CMS and other agencies
Work closely with state facilities and private agencies, assisting in their understanding of billing reports, requirements and billable service delivery
Track Medicare and Medicaid enrollment of facilities and providers
Ensure EHR implementation
Work closely with IT and DAS on system errors and on system changes including significant quality testing of systems