JOB SUMMARY: Under general supervision this position is responsible for supporting the design, development, and implementation of tools, analytics, and reporting, to include healthcare electronic data interchange applications. Conducts budget analysis and prepares financial reports. Overseas ongoing administration of related programs in fulfilment of the mission and vision of ANTHC.
Collaborates with the ANTHC Financial Department in maintaining, tracking, and controlling yearly expenditures for program related activity. Updates, reviews, manages and reconciles various accounts, balance sheets, general ledgers, statements, and spreadsheets. Develops, implements and maintains queries, forms and reports utilizing electronic databases. Processes required journal entries. Issues and tracks payments and refunds for assigned accounts.
Assists the PRC director in completing required operational and financial reports for program related activities, including but not limited to prior year tracking, refund requests, catastrophic health emergency funds, transient claiming, expanded services, and PRC Committee authorizations and denials.
Prepares various monthly, quarterly, and annual financial and operational reports. Extracts from various data sources, imports data into financial software program, analyzes data, and prepares reports. Verifies accuracy of data and ensures transactions are properly coded. Conducts audit preparation. Compiles with regulatory standards and policies and procedures of accounting.
Provides technical support during and after implementation for healthcare electronic data interchange applications. Responds to inquiries regarding EDI issues with enrollment, claims, payments, and/or clearinghouse activities. Conducts analysis of EDI transactions and is responsible for documentation and reports
Analyzes, forecasts, and prepares financial budgets. Conducts trend and cost analysis. Develop proposals for cost effective service line delivery to specialty and sub-specialty practice managers. Monitors and evaluates existing and potential opportunities for provider contract. Identifies and reconciles account discrepancies.
Prepare and maintains records, reports and statistical information to support development of metrics for operational improvements and/or strategic planning. Assists PRC Director and CFO in presentation of analysis and reports to leadership.
Ensures completion of administrative tasks such as check, purchasing, and travel requests. Reviews and maintains purchase records, travel reports, credit card reconciliation reports and other reoccurring invoices for program related activities
Recommends system improvements for operational and clinical processes. Works with programmers and other HIT departments in testing of software, identifying software problems and requesting enhancements and/or remediation based on business requirements. Uses existing HIT processes, procedures, best practices, and software whenever possible into daily work.
Periodically reviews system setups for accuracy and completeness, manage user accounts, table and file maintenance (vendor file, code sets, etc.).
Performs other duties as assigned.
KNOWLEDGE and SKILLS
Familiar with generally accepted accounting principles
Familiar with ad-hoc reporting tools
Knowledge of complex relational databases, electronic data interchange (EDI), and ad hoc reporting
Skill in written and verbal communications.
Skill in problem solving regarding information systems.
Skill in written and verbal communications.
Skill in effectively working with multiple internal and external service providers.
Skill in working with computers and software applications including word processing, spreadsheets, and database software.
Skill in effectively organizing multiple tasks, meeting deadlines and solving problems.
MINIMUM EDUCATION QUALIFICATION
A Bachelor’s degree in business, accounting, systems management, informatics or related field. Progressively responsible professional/exempt work experience may be substituted on a year-for-year basis for college education.
MINIMUM EXPERIENCE QUALIFICATION
Non-supervisory - Six (6) years of experience in healthcare finance, financial analyst, EDI analyst, systems analytics or related field. Proven ability to provide solutions in support of application users.
Experience with electronic health records, spreadsheets, and database management.
MINIMUM CERTIFICATION QUALIFICATION
PREFERRED EDUCATION QUALIFICATION
PREFERRED EXPERIENCE QUALIFICATION
At least one year Third Party Administration
PREFERRED CERTIFICATION QUALIFICATION
The following demands are representative of those that must be met by an employee to successfully perform the essential functions of this job:
Must be able to lift approximately 20 pounds.