The Benefit Analyst I is responsible for assisting with benefit system configuration. The position will support business initiatives with various departments such as Benefit Analyst II, Audit, Provider Data, Utilization Management, Claims and other operational departments. A thorough understanding of healthcare systems, data collection, analysis, strong organizational and record keeping skills are required.
Follow department workflow procedures to ensure maximum efficiency
Manage department email correspondence to the appropriate associate for review based on department assignments set by Supervisor, respond to work requests with estimated turnaround time parameters and continue to monitor any outstanding work requests to gauge appropriate follow-up communication
Manage Benefit Configuration department claims workgroup including auxiliary research to determine root cause. After review, assign escalated requests to Benefit Analyst II for immediate completion
Targeted operational reporting, data collection and ad-hoc report creation as requested by management
Maintain quarterly Claim Check edits as well as any other regulated CMS and DOD updates as identified by Supervisor
Create and maintain department policies and procedures
Maintain communication with Benefits Analyst II associates regarding CMS or DOD regulatory updates to ensure system compliance
Fallout management for external pharmacy claims data via batch load.
Other duties as assigned
Associates Degree Business/Health Information Management or equivalent healthcare experience
Advanced knowledge of ICD9-CM, ICD10,CPT-4, HCPCS codes
Prior experience working with TRICARE, Indigent Programs, Medicare Advantage, Health Care Exchange highly desired
Knowledge of UB-04 and HCFA claims processing
Excellent verbal and written communication skills
Ability to handle and resolve issues with minimal assistance
Ability to perform multiple tasks simultaneously
Proficient in Microsoft Office
Health Solutions Plus (HSP) experience preferred
Ability to adjust successfully to changing priorities and work load volume
CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.