APeX Claims Analyst

Applies skills as a seasoned clinical applications professional to projects of medium size at all levels of complexity, or portions of large projects.

The APeX Application Analyst will primarily be responsible for developing, supporting and maintaining Epic''s Professional and Hospital Billing Claims applications. They work under the direction of the Team Lead and/or Manager to configure, build, install and maintain the application. They coordinate all issues that arise during the project for their application area. Key operational activities include primary responsibility to analyze work flows and understand policies, procedures and constraints of the clinical or business operations support by the application. In depth and precise investigation and documentation of operational specifications and application functionality is required. Key technical activities include the analysis of new releases to determine how workflow should be modified, performing the build and conducting system testing. The application analyst develops and documents internal procedures and establishes change control processes for the application.

• Develops/design advance/complex programs and guides their develop with members of a cross functional team
• Works independently and in consultation with team lead and/or manager
• Application expertise to define "integrated" system design requirements and develop/implement complex application components
• Able to negotiate scope/approach with team, end users and IT infrastructure partners
• Principal contact for resolution of complex integrated issues and/or solutions
• Must have certification and strong experience with Epic Hospital Billing application.
• Ability to be a Subject Matter Expert in financial functionality related to Hospital Billing, revenue-cycle workflows, revenue-cycle user's support
• Meeting with operational partners to understand workflows, billing and collections, and overall revenue cycle requirements

Department Overview:

(please write a brief description of your department/unit that you would like to be included in the job posting/advertisement)

The Clinical Systems Applications Team is responsible for designing, testing, and implementing the clinical and business application aspects of UCSF's Electronic Health Record. This includes interoperability with other third party systems and devices.

Our Core Values include:

• Judgment: Makes wise decisions, root causes, thinks strategically, and prioritizes what to do now and what can be improved later.
• Communication: Listens well, concise and articulate in speech and writing, treat people with respect independent of their status or disagreement with you & maintain calm poise in stressful situations.
• Impact: Accomplish amazing amounts of important work, colleagues can rely upon you, focus on results, exhibit bias-to-action, and avoid analysis-paralysis
• Innovation: Find practical solutions to hard problems, suggest better approaches, new ideas that prove useful, stay nimble by minimizing complexity and finding time to simplify.

REQUIRED QUALIFICATIONS

• Bachelor''s degree in health care information technology, computer science, or related area, and/or equivalent combination of experience/training.
• Epic PB or HB Claims and Electronic Remittance Admin Certification
• 3 - 5 years of related work experience.
• Knowledge of systems and functions, including design, development, implementation, user support and training, maintenance, quality assurance, and system testing and evaluation.
• Strong problem-resolution skills, with the ability to quickly diagnose problems, and develop, test, and implement appropriate and effective solutions in a timely manner.
• Strong interpersonal skills, with the ability to effectively train, support, and work collaboratively with users of financial clinical information systems at all professional and technical levels.
• Detail-oriented, with proven organizational skills and the ability to effectively manage time, prioritize tasks, and see projects through to completion on deadline.
• Strong written and verbal communication skills, with the ability to convey technical information and instructions to all levels of clinical applications users in a specific, clear, and concise manner.
• Strong analytical skills and knowledge in documentation and reporting, with the ability to design and execute tests, analyze system performance data, and produce substantive reports and analyses.

REQUIRED CERTIFICATION

• Epic PB or HB Claims and Electronic Remittance Admin Certification

PREFERRED REQUIREMENTS

• Ability to work with senior staff and managers, serving as a technical resource and providing advice and counsel on issues of functionality, efficiency, cost-effectiveness, policy, and performance.
• Able to run Chronicles queries/create a reporting subset
• Strong Excel skills to create import templates, pivot tables, vlookup queries, etc
• Experience in support of file transfer protocols
• Home Health/Hospice Billing experience
• Experience with Epic Claim Attachments
• Familiar with Epic Payor/Plan concepts and build
• Knowledge of claim reconciliation workflows
• Epic PB Admin Certification
• Epic HB Admin Certification
• Epic Dental Billing Badge

%

of time

Essential Function (Yes/No)

Key Responsibilities

(To be completed by Supervisor)

25

YesPlans, implements and supports clinical software, hardware, operating systems and / or distributed clinical information systems of moderate scope and complexity. Contributes to estimates of resource needs and scheduling of system upgrades and modifications.

10

YesWorks on complex initiatives to analyze patient care workflow in various clinical departments, and to develop and define information technology solutions for improved system integration and functionality. Organizes medical record tools and data. Applies innovation in management of complex scenarios.

10

YesCollaborates with key operational users on complex projects to modify workflow due to new releases and system upgrades. Plans and develops improvements in functionality and efficiency of clinical applications. Liaison between vendors and IT leadership.

10

YesContributes to the development of new projects at all levels of scope and complexity. Performs systems analysis, planning and preparation, coding, testing, implementation and client / vendor coordination.

15

YesDesigns and conducts user training in clinical information system workflows and processes, hardware and / or operating systems at all levels of complexity. Develops effective tools and aids for systems training.

15

YesTroubleshoots escalated issues of moderate complexity and scope with clinical software, hardware, operating systems and / or distributed clinical information systems. Identifies and coordinates service and support as needed between clinical engineering, IT, networks, departments and outside vendors. Proposes new solutions in regards to workflows, processes, system designs or developments as needed.

5

YesParticipates in development of complete, concise and comprehensive polices and operation procedures to assist in communicating issues to management staff

5

YesRealigns based upon business and clinical needs. Looks to new opportunities to address customer service challenges. Documents issues and develops / communicates plans to address.

5

YesEstimates project time requirements, addresses gaps, participates in feasibility assessments.

100%

(To update total %, enter the amount of time in whole numbers (without the % symbol - e.g., 15, 20) then highlight the total sum (e.g., 1%) at the bottom of the column and press F9. The total sum should add up to 100%.)

%

of time

Essential Function (Yes/No)

Key Responsibilities

(To be completed by Supervisor)

25

YesPlans, implements and supports clinical software, hardware, operating systems and / or distributed clinical information systems of moderate scope and complexity. Contributes to estimates of resource needs and scheduling of system upgrades and modifications.

10

YesWorks on complex initiatives to analyze patient care workflow in various clinical departments, and to develop and define information technology solutions for improved system integration and functionality. Organizes medical record tools and data. Applies innovation in management of complex scenarios.

10

YesCollaborates with key operational users on complex projects to modify workflow due to new releases and system upgrades. Plans and develops improvements in functionality and efficiency of clinical applications. Liaison between vendors and IT leadership.

10

YesContributes to the development of new projects at all levels of scope and complexity. Performs systems analysis, planning and preparation, coding, testing, implementation and client / vendor coordination.

15

YesDesigns and conducts user training in clinical information system workflows and processes, hardware and / or operating systems at all levels of complexity. Develops effective tools and aids for systems training.

15

YesTroubleshoots escalated issues of moderate complexity and scope with clinical software, hardware, operating systems and / or distributed clinical information systems. Identifies and coordinates service and support as needed between clinical engineering, IT, networks, departments and outside vendors. Proposes new solutions in regards to workflows, processes, system designs or developments as needed.

5

YesParticipates in development of complete, concise and comprehensive polices and operation procedures to assist in communicating issues to management staff

5

YesRealigns based upon business and clinical needs. Looks to new opportunities to address customer service challenges. Documents issues and develops / communicates plans to address.

5

YesEstimates project time requirements, addresses gaps, participates in feasibility assessments.

100%

(To update total %, enter the amount of time in whole numbers (without the % symbol - e.g., 15, 20) then highlight the total sum (e.g., 1%) at the bottom of the column and press F9. The total sum should add up to 100%.)