EDI Revenue Cycle Analyst

California  ‐ Onsite
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Keywords

Description

Health Care Revenue Cycle Analyst needed in Pasadena - WE WANT TO TALK TO YOU!

As a global business and technology consulting services leader, Enclipse focuses on delivering tangible solutions. 

By employing a team committed to questioning and challenging the status quo, Enclipse has established a culture that encourages independent thought, innovation, and flexibility.

If you join Enclipse, you can expand your technology platform while working for the Nation's most dynamic Health Care Leader.

We Provide:

  • Class A Benefits  that Start ASAP
  • The Personal Touch -- You deserve it, We deliver it!

Contract Terms: W2

Pasadena, CA 91103

6 + Months

BB37743

Primary Purpose: focus on EDI end to end reconciliation for DHMO

Position Summary:
Responsible for a range of process improvement and process management activities. Activities include planning, performing, and implementing process improvement initiatives, in addition to ownership of operational processes. These initiatives may represent one portion of a larger project, or may represent a stand alone initiative or function within a work group or department. Process management functions may include data gathering and analysis, best practice research, process mapping, developing and recommending alternatives for improvement, developing performance metrics, obtaining leadership or stakeholder agreement, implementing improvements, and monitoring post-process improvement initiative performance to updated standards. Activities are undertaken and executed in support of organizational goals and are accountable for providing business process solutions to meet internal and external customer expectations. May utilize Lean/Six Sigma processes and concepts to lead process improvement initiatives. Partners with management, project champions, and process owners to execute the project and deliver results.

Education/License/Certification:
Bachelor's degree or equivalent experience required

Qualifications:
2-4 years of process improvement, consulting, or related business experience with knowledge of process improvement methodologies

Preferred Qualifications:
5-8 years of process improvement, consulting, or related business experience.

Duties:

Data Analysis:
Identifies data source, gathers and analyzes data relevant to processes identified for process improvement initiatives.
May recommend data requirements.

Research:
May research and summarize best practice standards relevant to process management. Makes recommendations on appropriate solutions based on research.

Process Architecture:
Designs processes using defined methods.
Ensures process mapping is complete; provides feedback and guidance to less senior analysts/consultants.
Interviews stakeholders and process owners to define processes.

Process Recommendations:
Prepares process recommendation documents, including presentations, process maps, supporting metrics, business requirements and related impact analyses for less complex processes or for portions of larger or inter-related processes.
May apply Lean/Six Sigma concepts and techniques to process improvement initiatives, including completing Lean/Six Sigma analyses and tasks.

Performance Management & Control:
Develops performance metrics to establish process success.
Reviews data post- implementation to measure outcomes and impacts.
May develop recommendations to minimize impacts.

Change Management:
Participates in change management activities associated with process improvement.
Engages leadership and stakeholders to obtain support and buy in for changes.
Partners with management, project champions, and process owners to align process improvement initiatives with business objectives.

Works on assignments of diverse scope and within broadly defined practices and guidelines. Modifies or suggests enhancements. Uses judgment within defined practices and procedures. Participates in determining objectives of assignment. May refer to established precedents and policies when making decisions. Works under limited direction and work is reviewed by management at key intervals for advice and guidance prior to completion. Has no formal supervisory responsibility, however, serves as a technical coach to team members, providing periodic informal work guidance,/direction to, and training of team members.

In addition to defined technical requirements, accountable for consistently demonstrating service behaviors and principles defined by the client Service Quality Credo, the CLIENT Mission as well as specific departmental/organizational initiatives. Also accountable for consistently demonstrating the knowledge, skills, abilities, and behaviors necessary to provide superior and culturally-sensitive service to each other, to our members, and to purchasers, contracted providers, and vendors.

Deliverables:
contractor position till end of year - for EDI support for PFS
Daily reconciliation of all 837 data to Diamond from CLIENTHC - may be manual in beginning
Daily reconciliation of 835 date from Diamond from CLIENTHC
Second tier reconciliation of Self Funded
Documentation of workflow(s) for validation process
Research missing inbound/outbound files per daily reconciliation for processing
Operational Reporting

TOP 3
Experience with healthcare Electronic data specifically 837, 835 and 277 transactions and files

Experience in data crunching and reconciling and matching data in excel and other data tools.

Epic experience preferred not required

Start date
n.a
From
Enclipse Corp.
Published at
13.06.2013
Project ID:
551010
Contract type
Freelance
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