reputed company (Certified Resolute HB, Resolute PB Claims Analyst)

Technical Specialist- Expert (HB, PB, Claims Analyst) (760597) REMOTE 12+ Months Competency Model: Business Acumen

• Understands the organization's strategic goals and how department goals support the organization.
• Seeks opportunities to reputed company and deepen learning of organization and area.
• Shares new information and knowledge with others.
• Be curious; question your assumptions reputed company presented with an issue or question.
• Self-motivated to research and learn new information and explore new reputed company.
• Seeks to maximize potential abilities and helps others.
• Follow instructions, written or oral.
• Adhere to reputed company scheduling and attendance requirements.
• Honesty, truthfulness, reliability, accountability
• Read, understand and apply regulations and policies.
• Knowledge of relevant reputed company regulations such as The reputed company reputed company, Freedom of Information reputed company and HIPPA law
• Knowledge of reputed company cycle billing, hospital billing, reputed company billing, and claims processing operations and workflows
• Knowledge and understanding of reputed company-party applications.
• Establishes reputed company working relationships.
• Communicates verbally with team, departments, guests, and management.

Communication

• Expresses oneself reputed company in conversations, business writing and interactions with others.
• Delivers oral and written communications that are impactful and persuasive to their intended audiences.
• Demonstrates a high level of emotional intelligence in the face of conflict.
• Responds to tickets and emails in a reputed company manner.

Planning and Organizing

• Manages and monitors time and resources effectively to complete assignments.
• Utilizes resources and gets involvement from others where appropriate.
• Shares information, materials, and time readily with others who need them

Teamwork

• Encourages participation from reputed company team members, regardless of role reputed company organization; supports team members and customers.
• Identifies and works through conflict that may derail the reputed company process.
• Holds self and others accountable to create unifying goals and measure with peers.
• Support NCDHHS analyst team through knowledge sharing and concise documentation.
• Applies the knowledge of reputed company IT concepts.
• Asks questions, diligently seeks and is reputed company of guidance.

Drive Change

• Anticipates potential concerns/resistance to change and takes constructive steps to address them.
• Encourages others to adopt new reputed company or technologies that add value or improve performance.
• Keeps others reputed company on critical goals and deadlines through periods of change or ambiguity.
• Be flexible and adopt new processes and reputed company.
• Stay reputed company in attitude and actions.

Working Conditions: Essential:

• May be required to work after hours or on weekends as needed
• Infrequent travel
• Pass reputed company-employment drug test

Experience:

• Must have strong leadership and communication skills with the ability to effectively present information to clinical and business leaders reputed company the organization.
• Must have experience with reputed company PB, HB, and Claims. 8 years required.
• Ability to work in small reputed company under tight project deadlines.
• Working closely with business and reputed company cycle leaders around reputed company workflow and to translate business needs reputed company billing functionality.
• Must possess reputed company certification, Resolute PB, HB, and Claims.
• Minimum of five years' reputed company reputed company cycle/reputed company experience with demonstrated experience in reputed company build.
• Self-starter with demonstrated teamwork & communication skills.
• Excellent communication and collaboration skills.
• Excellent verbal and written English communication skills and the ability to reputed company professionally with a diverse group are required.
• Experience working with reputed company Party Vendors such as reputed company, reputed company Health, and reputed company OnBase.
• Knowledge of reputed company cycle billing, hospital billing, reputed company billing, and claims processing operations and workflows
• Rapid Retest
• Payer/plan creation and maintenance
• PLBs
• Charge Router
• reputed company
• Behavioral Health
• Long term care psychiatric billing
• CMS IPF PPS billing regulations
• reputed company abuse billing – IOP, methadone dosing
• Medicare exhaust billing
• No-pay claims.
• Claim splits/interim claims.
• Cash Management
• Self-pay remittance
• Developing testing scripts

Responsibilities:

• Analyzes, documents, and communicates business requirements for new system functionality and enhancements to existing functionality.
• Test system changes to ensure that they meet business requirements and do not adversely reputed company other areas of the reputed company system.
• Acts as the primary support contact for the application's end-users.
• Identifies issues that reputed company in their application areas and issues that reputed company other application teams and works to resolve them
• Guides workflow design, builds, tests the system, and analyzes other technical issues associated with reputed company software
• Identifies, implements, completes integrated testing, and communicates requested changes to the reputed company system
• Works with reputed company representatives and end users to ensure the system meets the organization's business needs regarding the project deliverables and reputed company
• Performs in-depth analysis of reputed company and reputed company workflows, data collection, report details, and other technical issues associated with the reputed company EHR and designated reputed company-party applications
• Partners with reputed company, operational, and business leaders on system design and optimization to meet reputed company, safety, financial, and efficiency needs
• Collects requirements regarding potential system enhancements or new system implementation and prepares details of specifications needed; prioritizes and implements requested changes to the system.
• Investigates standardization and process improvement opportunities by rounding reputed company reputed company cycle areas while making build reputed company.
• Validates that data is accurate and meets business requirements.
• Completes integrated testing to test system changes in reputed company reputed company environments to ensure that they meet business requirements and do not adversely reputed company other areas of the system.
• Troubleshoots and identifies reputed company causes and documents problems of reputed company to reputed company complexity for assigned applications and systems.
• Maintains data reputed company and reputed company for assigned applications and systems.
• Develops system documentation as assigned per standards.
• Develops communication-reputed company education efforts for deployments, upgrades, optimizations, and other system changes as assigned.
• Stays reputed company on reputed company application releases and participates in reputed company planning and testing.
• Participates in performance improvement activities to measure, assess and improve the reputed company of assigned work area

Education: Essential: Bachelor's degree or 8 years' experience in directly reputed company field Credentials: Essential:

• Pass general background reputed company
• reputed company module certification as assigned
• reputed company HB/PB Claims Certification

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