Summary:

Under the supervision of the Configuration Manager, the Payment Integrity Analyst Senior is responsible for interpreting results using a variety of techniques; ranging from simple data aggregation via statistical analysis to complex data mining independently. Maintenance and building of fee schedules for provider contracts.

Responsibilities:

? Lead and perform complex analysis in an evolving data environment
? Lead projects that require data mining, analysis, and presentation
? Identify relevant trends, do follow up analysis and prepare visualizations
? Extract and analyze data, patterns, and related trends, with the subsequent ability to synthesize the data into information consumable by business
decision-makers
? Uses advanced research and statistical methods to conduct comprehensive analyses on the data collected from various operational processes
? Consults with requestors of informational topics related to research and decision-making analyses
? Performs other duties as assigned
? Uploading and exporting new fee schedules from CMS, Tricare (CHAMPUS), or custom into claims system.
? Research and maintaining updates of current fee schedule that are made in CMS and Tricare (CHAMPUS).
? Ability to gather and analyze data, reason logically, draw valid conclusions and make appropriate concise information and recommendation
available in both oral, written and visual formats
? Knowledge of data relationships, how data is input (manually and electronically) into the system, and how the data is reported
? Possess analytical skills related to the development of report specifications, data reporting and data modeling

Requirements:

• Bachelors Degree Preferred
• Strong background in analysis, design, development, testing and support of complex information systems with an emphasis on data integrity and quality control
• Strong Microsoft Office application skills including Microsoft Word and Excel (VLOOKUP, Pivot Tables, Index/Match, Formulas, and creating spreadsheets)
• Strong understanding of healthcare claims data, pricing, and claims editing concepts, including UB04 and HCFA 1500 claim content
• Experience with interpreting complex provider agreements
• Experience in healthcare claims adjudication, system configuration, and auditing 
• Minimum of 6 years of experience working with data analytics (preferably in healthcare)

Work Schedule:

MULTIPLE SHIFTS AVAILABLE

Work Type:

Full Time

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About CHRISTUS Health

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.

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