Responsible for supporting enterprise wide data systems and department objectives including the ensuring of data integrity, data audits, data analysis and additional business-critical functions. Assists with management of large data analysis requests as well as identify opportunities for automation to
streamline processes. Serves as lead supporting technical development of other analysts. Acts as a Subject Matter Expert (SME) and escalation specialist related to problems or situations within the EDI environment.
1. Manages various components of the database including, but not limited to, accuracy, reporting to other systems, data collections/retrieval, creates and edits reports, documents, and queries from database.
2. Develops and manages processes and audit functions to monitor and ensure data integrity and uniformity.
3. Analyzes updates to system modules to ensure data integrity and accuracy.
4. Research, manipulate and analyze data to identify trends and implications.
5. Supports multiple assignments and is able to shift priorities in accordance with need and maintain confidentiality of sensitive information.
6. Assists with training staff on revenue cycle system optimizations as necessary including the development of training materials and resources.
7. Ability to communicate well and present findings interacting personally or verbally with both internal and external customers to share information, provide direction, and consultation.
8. Maintains professional development and technical competency.
9. Manages, coordinates, and champions multiple revenue cycle initiatives across the organization to improve processes and support the revenue cycle mission.
10. Discovers opportunities for process improvement through data analysis and collaborating with other departmental leaders; articulates the business case for such changes.
11. Designs, implements and evaluates improvement aimed at increased efficiency; supports the assessment of current revenue cycle functions.
12. Interfaces with finance, claims, provider relations, third-party processors, and account management to review and resolve EDI related issues.
13. Generates, transmits, reviews applicable EDI reports, to ensure completeness, accurateness, data integrity, mapping and currentness.
14. Support the processing, troubleshooting and management of EDI X12 transactions.
15. Analyze, design, develop, test, implement, and support new EDI integrations.
16. Analyze current EDI implementation to make recommendations for improvements.
17. Performs other duties and responsibilities as required.
MINIMUM EDUCATION REQUIRED:
Bachelor’s degree in Information Systems Applications, Health Information Systems, Informatics, Management Information Systems or closely related field required. In lieu of degree, six (6) years of relevant work experience will be accepted in addition to the experience requirement.
MINIMUM EXPERIENCE REQUIRED:
Three (3) years of experience in Revenue Informatics and healthcare revenue cycle experience.
(If no degree, a total of nine (9) years of experience required).
MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:
Two (2) years of experience working with EDI codes sets for electronic billing and collections preferred.
Exceptional organizational skills required.
Superior written and verbal communication skills including the ability to present ideas in a clear and compelling manner to both executive and staff level audiences.
Previous experience using or implementing Epic is desired.