Analyst

Roles and responsibilities

We are seeking an Analyst in Clinical Billing Compliance to support our service and procedure compliance program. This role involves analyzing medical records for documentation standards, ensuring correct billing, and providing education based on audit findings. The position is crucial for maintaining billing compliance and accuracy across clinical areas.

Key Responsibilities

Review medical records to ensure compliance with documentation standards.
Analyze coding and charging processes, particularly in high-value departments such as Emergency Rooms and Specialty Clinics.
Support the compliance program by providing thorough analysis and recommendations.
Educate and train clinical teams based on audit outcomes.
Adhere to company standards, including those related to conduct and conflict of interest.
Perform additional duties as required to support the department’s needs.
Data Collection and Analysis

Data Gathering: Collect and compile data from various sources, including databases, reports, and surveys.
Data Analysis: Analyze data to identify trends, patterns, and insights that inform decision-making.
Reporting

Report Generation: Prepare detailed reports and presentations that summarize findings and recommendations.
Dashboard Creation: Develop dashboards and visualizations to present data in an easily understandable format.
Problem Solving

Identify Issues: Recognize and define problems or inefficiencies within processes or systems.
Solution Development: Propose actionable solutions based on data analysis and research findings.
Collaboration

Cross-Functional Support: Collaborate with various teams (e.g., marketing, finance, operations) to support data-driven decision-making.
Stakeholder Engagement: Work with stakeholders to understand their needs and tailor analyses to meet those requirements.

Desired candidate profile

Bachelor’s Degree in commerce, health information, or a relevant discipline.
At least 3 years of experience in charge description auditing, compliance audits, and insurance claims auditing in a hospital setting.
Coding certification from AAPC or AHIMA.
Proficiency in Microsoft Office and fluency in English.
Analytical Thinking: Strong analytical skills with the ability to interpret complex data sets and derive actionable insights.
Communication Skills: Excellent verbal and written communication skills for effectively presenting findings.
Experience
experience in a data analysis, business analysis, or related role, preferably in a relevant industry.
Project Experience: Experience in working on projects that involve data analysis and reporting.
Technical Skills
Data Tools: Proficiency in data analysis and visualization tools (e.g., Excel, Tableau, Power BI).
Statistical Analysis: Understanding of statistical methods and techniques for data analysis.
Soft Skills
Attention to Detail: High attention to detail to ensure accuracy in data analysis and reporting.
Problem-Solving Ability: Strong problem-solving skills to identify issues and develop solutions.
Personal Attributes
Curiosity: A keen interest in exploring data and a desire to understand the “why” behind the numbers.
Adaptability: Ability to adapt to changing priorities and work effectively in a fast-paced environment.
Additional Qualifications
Certifications: Relevant certifications (e.g., Certified Business Analyst Professional (CBAP), Data Analyst Nanodegree) are a plus.
Industry Knowledge: Familiarity with the specific industry (e.g., finance, healthcare, technology) can enhance effectiveness.