Clinica Family Health Services
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System Data Analyst (EPM)
at Clinica Family Health Services
This job exists to: set up and maintain our EPM. This position will support Billing, Coding and Finance.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
• Collaborate with Finance, Accounting, Billing and Coding to ensure the system is set up and maintained in the best way to fit Clinica’s needs.
• Maximize System utility
• Streamline and improve EPM workflows
• Providing exceptional customer service to internal and external customers External Reporting & Compliance
• Ensure system is set up to meet and comply with state and federal billing regulations.
• Continuous Improvement Projects
• Seeking opportunities to improve NextGen Software functions, Billing and Coding processes such as those to:
o Increase system efficiency
o Decrease manual workflows
o Increase reimbursement
o Increase accuracy (Quality)
• Serves as Internal NextGen Support.
• Troubleshoot and resolve issues with EPM. Refer calls beyond technical scope to EPM, E.H.R., EDR managing partners or vendors.
• Encourages innovation and process improvement within the Finance team.
• Complies with all guidelines established by the Centers for Medicare and Medicaid (CMS) and guidelines set forth by other regulatory agencies, where applicable. Participates in the development and implementation of insurance billing procedures.
• Collaborates with the Billing and Coding teams to assure the system is set up and maintained in order to maximize revenue within corporate compliance.
• Contributes to additional training projects and special projects as required
• Prepares reports as needed and summarize information to verify accuracy as requested.
• Participate in system upgrade for EPM
• Maintain a positive attitude and fun work environment for fellow staff resulting in teamwork and productive collaboration with the site Operations and Clinical teams Operational Objectives
OTHER DUTIES AND RESPONSIBILITIES
• Maintain a safe work environment by remaining informed of and compliant with the clinic’s safety policies, and in particular by application of safe practices in area of own responsibility.
o Knowledgeable of and compliant with all laws and regulations governing area of responsibility.
o Responsible for reporting any potentially non-compliant conduct.
o Cooperate fully with our Compliance Officer in upholding our Compliance Plan.
• Serve as a resource in on-going support of staff using EPM. Assist in the evaluation and implementation of upgrades and assure a smooth transition to these new systems.
• Train Finance staff in EPM, partner with other departments for training as needed.
• Generate reports as needed to improve the revenue cycle and ACO Program performance.
• Generate reporting for quality incentive opportunities.
• Is part of the Finance team and partners with members of the team in strategic planning processes and implementation.
• Serves as liaison for Billing, Coding, Clinical Services, Training EHR, ACO and IT, troubleshooting and resolving issues.
• Participates on committees and in meetings as directed by their Manager.
• Perform other duties and responsibilities, including billing, as required.
SCOPE OF AUTHORITY: Progress is reviewed quarterly and results are measured and formally evaluated annually.
A. Education / Experience:
• Associates degree in Computer science or equivalent training and job-related experience required.
• 3 years of medical billing and coding experience preferred.
• Community Health Center experience preferred.
• EPM Certification a plus.
• Experience with NextGen EHR and EDR a plus.
B. Knowledge, skills and abilities:
• Office skills including typing, accounting, 10 key entry, and computer terminal usage required.
• Ability to communicate to up line and down line staff in a professional and succinct manner.
• Basic understanding of ICD-9, ICD-10 Medical Coding and Current Procedural Terminology (CPT), Current Dental Terminology (CDT), HCPCS, is required.
• Basic knowledge of medical terminology, abbreviations, techniques; anatomy and physiology; major disease processes; pharmacology; and the metric system to perform daily functions.
• Solid understanding of Medicaid, Medicare, Commercial insurances and other payers required.
• Microsoft Office required.
• Organizational, analytical, decision making, creative thinking, time management, problem solving and interpersonal skills.