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Data Resolution Specialist Administration Shared Cost MSHC

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Location: Buffalo, NY, United States

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Job Description

Facility: Administrative Regional Training Cntr

Shift: Shift 1

Status: Full Time FTE: 1.000000

Bargaining Unit: ACE Associates

Exempt from Overtime: Exempt: No

Work Schedule: Days

Hours: 8:00am to 4:00pm Monday - Friday

Summary:

The Data Resolution Specialist improves the timeliness and accuracy of billing by streamlining batch error correction of system identified errors so that claims may be processed in a timely fashion, thus maintaining the cash flow of the agency. Processes and reports are created by the Data Resolution Specialist to identify and resolve errors that are holding bills and impacting Oasis submissions to CMS. The processes and reports are analyzed by the Data Resolution Specialist to identify and trend errors. From the trends identified, the Data Resolution Specialist will provide educational feedback as appropriate to the Clinicians, Clinical Supervisors and/or Staff Educators to prevent these errors in the future.

The Data Resolution Specialist provides ongoing training and review of billing sequences, assessment creation and data reconciliation with the appropriate staff. The Data Resolution Specialist will assist in improving communication between billing and operation/clinical staff by being available to answer billing issues. The Data Resolution Specialist will be cross trained to assist with other department operations and workflows including Scheduling, Intake, HIM and Utilization Management, as determined necessary by the VP of Operations.

Responsibilities:

EDUCATION
  • Associates Degree in Business or health related field required.
  • In lieu of a degree, extensive experience in clinical healthcare operations, authorization or billing.

EXPERIENCE
  • Minimum of two (2) year's experience in computer related tasks or operation of a computer.

KNOWLEDGE, SKILL AND ABILITY
  • Strong knowledge of State, Federal, Medicare and Medicaid regulations.
  • Strong knowledge of Clinical EMR functionality, specifically billing and error resolution.
  • Understands and practices the ethical, professional and legal obligations of the Catholic Health System Corporate Compliance Program.
  • Excellent written communication, organization and problem solving skills.
  • Detail oriented.
  • Exceptional problem solving ability and communication skills required.
  • Expert knowledge of billing processes.
  • Understands the Clinical EMR error reports - how to run them, what data fields are pulled, how to correct the errors.
  • Able to work as part of a team and interact with other departments.
  • Knowledge of general office equipment operations and supplies.
  • Understands and maintains the CONFIDENTIAL nature of the information handled and discussed.
  • Organized and able to work independently.
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