Senior Claims Analyst

Full Time
San Leandro, CA 94577
Posted Today
Job description

******PLEASE NOTE: OUR IT TEAM IS CURRENTLY WORKING REMOTELY PER CDC AND ALAMEDA COUNTY SHELTER IN PLACE MANDATE, HOWEVER, ONCE S.I.P. MANDATES ARE LIFTED, THE IT TEAM IS EXPECTED TO RETURN ONSITE, BUT WILL ACCOMMODATE SOCIAL DISTANCING REQUIREMENTS PER LOCAL AND STATE REGULATIONS.*****


Alameda Health System is seeking an experienced Senior EPIC Claims and Remittance Analyst with strong emphasis on revenue-cycle workflows and revenue-cycle user’s support.



At Alameda Health System, we are dedicated to creating a positive and safe work environment for our patients, staff, and community. We promote equity of experience and opportunity to ensure staff of all background feel included and welcome.


Role Overview


As the Senior EPIC Claims and Remittance Analyst, you will design, build, test, and implement clinical application systems. You will provide support to revenue-cycle workflows and revenue-cycle users through knowledge of clinical processes, documentation needs, and clinical practice standards when adapting software to meet their needs.


You will work closely with clinicians to create and/or adapt written protocols and prepare detailed specs encompassing clinical processes, information flow, risk, and impact analysis. Additionally, you will provide customer service, troubleshooting, and maintenance. As a technical leader in clinical applications, you will apply advanced professional concepts and extensive industry knowledge to lead and/or work on medium to large projects of broad scope and complexity.





Responsibilities


NOTE:
The following are the duties performed by employees in this classification, however, employees may perform other related duties at an equivalent level. Not all duties listed are necessarily performed by each individual in the classification.


  • Act in an appropriate and professional manner as defined by the company’s Standards of Behavior, Policy and Procedures, and Scope of Services.

  • Role model AHS Standards of Behavior.

  • Provide subject matter expertise to team as needed. Assists management during employee orientation

  • Advise leadership in the development of strategies for EHR implementation and improvements of AHS workflow processes

  • Leads workflow design discussions, building and testing the system and analyzing associated issues.

  • Identifies issues that arise in assigned application area as well as issues that impact other application teams

  • Guides end users in ongoing training during all phases of implementation

  • Reviews the status of deliverables, issues and milestones with leadership.

  • Serves as a liaison between end users’ workflow needs and Epic implementation staff.

  • Performs other duties as required.

  • Function effectively and independently with minimal direction.

  • Manipulate complex, confidential data - with minimal direction.

  • Recommends strategy, plans, and alternatives to the senior leader proactively.

  • Proactively advise senior leaders of obstacles and impediments to maintaining schedules and milestones.


Qualifications:


Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying.


Required Education:
Bachelor’s degree in a relevant field from an accredited college or university.


Preferred Education: Master’s Degree in Information Technology


Required Experience
: Six (6) years Information Technology experience within a multi-entity, healthcare environment.


Preferred Experience: Prior Epic implementation experience with EPIC Claims and Remittance; experience with clinical applications in either inpatient or outpatient setting; experience with revenue cycle as it relates to Claims and Remittance applications or patient access services.


Required Licenses/Certifications:
Current Epic certification in Claims & Remittance or attainment of Epic certification within six months of employment.


Additional Information:


Epic Claims & Remittance Administration certification
and minimum three years’ experience implementing and/or supporting Epic's Claims & Remittance application as an IT analyst/builder. This position requires depth and breadth of knowledge from an IT software application perspective, problem-solving and analytical thinking, data analysis/manipulation in Excel.




Prior experience integrating Epic's Claims application with third-party software, ability to configure Epic to pull info from upstream applications onto the claim form. Prior experience setting up claims for various service-lines e.g. inpatient acute, outpatient, skilled nursing facilities, long-term care, inpatient rehabilitation, and dental claims is preferred. Knowledge of Medi-Cal (California Medicaid) and Medicare billing requirements is very desirable.

As a Senior/Lead Analyst, the candidate is expected to be comfortable and experienced leading an application implementation and upgrade projects. Local candidates preferred but relocation candidates will be considered. This position will participate in a rotating on-call schedule.


ALAMEDA HEALTH SYSTEM EMPLOYEES ONLY: This position is eligible for a $5,000 employee referral bonus to employees who refer candidates via the Role Point Referral Portal that are successfully hired. For more information on the Employee Referral program & eligibility, please visit the Recruitment Intranet page:http://ahsconnects/departments/recruitment-services/employee-referral/


Information Systems
SYS IS Apps Rev Cycle
Full Time
Day
Business Professional & IT
FTE: 1

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