What are the responsibilities and job description for the Information Systems Analyst I position at DAYMARK RECOVERY SERVICES INC?
Job Details
Description
Summary: The Information Systems Analyst I routinely executes processes using EDI configurations to exchange data with payer systems. The position routinely analyzes datasets to validate trends in EDI production with corporate productivity while also identifying necessary reactions to EDI exceptions. Executes ad hoc queries to fulfill managerial reporting requests and to identify deficiencies in the practice management database.
Essential Duties and Responsibilities:
|
Percentage |
Duty or Responsibility |
|
70% |
ANSI EDI creation and submission to various payer systems |
|
10% |
Maintains ongoing knowledge of Federal/State/Local rules and regulations pertaining to HIPAA, Medicaid, Federal DHHS, State DHHS, MCOs through research, peer engagement, workshop attendance, communication bulletins, and close communications with payer contacts. |
|
5% |
Maintains working knowledge of the agency EHR and Practice Management systems to adapt systems to changing external forces, such as changes to HIPAA transaction standards that require modifications to EDI file processing. |
|
5% |
Working with payers to ensure EDI protocols result in low levels of transaction denials while also working with agency staff to ensure they are aware of their own patterns of actions that result in transaction denials, i.e., failure to credential staff for failure to pre-authorize services. |
|
5% |
Works closely with Reimbursement department and Data Support department to troubleshoot errors and denials and coordinating dependent interdepartmental transactions such as enrollments and claim submissions. |
|
5% |
Any other duties as assigned |
Special Attributes: Must possess a good attitude, work well with staff at all levels of the agency and stakeholder agencies, be committed to working as part of a team, have a strong commitment to patient care, understand office flow, understand budgeting and have knowledge of Mental Health, Social Work or Health Care Fields.
Qualification Requirements: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
- Minimum 1 year experience working with ANSI standard files
- Extensive knowledge of version 5010 HIPAA-based ANSI EDI standards (837P, 835, 270, etc.)
- Knowledge of techniques for ad-hoc report generation using standard and/or proprietary tools such as Crystal Reports, Database Search, Data Management Center.
Education and/or Experience: Must possess at least a High School Diploma. Bachelor degree in computer science, business, or related field preferred. Actual work experience will be taken into consideration in lieu of education.
Qualifications
