ADAMH Business Systems Analyst

ADAMH

ADAMH BOARD of FRANKLIN COUNTY

Job Description

Position Title: Business Systems Analyst

Job Description

The ADAMH Board of Franklin County is currently implementing a new health care management information system to support management of client enrollment, benefit management, provider contracting, payment processes, and utilization and outcomes management known as the Shared Health and Recovery Enterprise System (SHARES).

The SHARES Business Systems Analyst will be responsible for analyzing, implementing, troubleshooting, and providing the necessary support to internal and external customers related to member enrollments, claims, and the SHARES system. This position will work closely with multiple departments (ex. Membership/Enrollment, Finance, Clinical, IT) for SHARES related functions.

Primary Responsibilities/Expected Outcomes:

  • Provides Customer Service and acts as liaison between provider and ADAMH to maintain accurate submission of enrollments and claims. Assists in troubleshooting member enrollment, claims, and any other issues by responding to phone calls, e-mails, and Helpdesk Ticket System (Phaseware) inquiries in a timely manner to effectively resolve issues. Performs tasks in all areas of claiming and enrolling and processing new and ongoing members as needed. Analyzes and reviews member enrollments and claims for accuracy, completeness and eligibility as needed.
  • Assesses customer and/or business process requirements; analyzes structure and flow of work and data that support needs; evaluates possible solutions and implements and/or recommends solutions that support the mission, values and goals of ADAMH. Leads ad hoc projects as assigned to identify or understand business problems/needs, and to analyze, design, recommend and/or implement a technical solution.
  • Participates in/on a variety of meetings, groups, and/or committees to communicate and confer about process analysis of existing procedures and systems, determine cost/benefit and complexities of new processes and projects.
  • Leads project improvement processes. Participates in testing, planning the roll-out of new processes, projects and software upgrades, and/or discuss other applicable issues.
  • Independently performs all duties relating to assigned claims processing functions in SHARES. Reviews, analyzes, troubleshoots, and correct claims – upon claim denial/rejection
  • Assists/facilitates training of ADAMH staff and Network of Providers on SHARES system, including claim processing: successful submission, claim corrections, claims trouble-shooting, and member enrollment processes.
  • Develops technical assistance materials and manuals as needed
  • Understands and works diligently to maintain the security of the member’s PHI.
  • Assists Fiscal Department in supportive functions, such as configuring and maintaining Provider setup, rate schedules, benefit plans, and other configuration tasks in SHARES as needed.
  • Perform other related duties as assigned.

Education and Experience

  • Bachelor’s Degree in business or technical discipline or an equivalent combination of education and experience; one to three years’ experience with business analysis.
  • Minimum of Three years of relevant experience in all areas of both enrollments and claims, with strong emphasis on understanding the interactions between enrollments and claims.
  • Strong Problem Solving/Analysis ability. Demonstrated capacity for implementing new and improved processes.
  • Knowledge of software development lifecycle and software quality assurance principles and practices is a plus
  • Prior experience in systems administration in behavior health care management is a plus.
  • Experience with EHR (Electronic Health record) systems / HMS (Health Management Systems) is preferred.
  • Prior experience with financial systems, billing, and clinical knowledge is a plus.
  • Demonstrated performance and commitment to good quality internal and external customer service and dedication to resolving customer’s concerns and questions.
  • Ability to work independently and as a team player focusing on improving business operations
  • Able to work effectively in team environment with a wide variety of culturally diverse consumer, staff, and public.
  • Strong interpersonal skills and ability to work with both technical and non-technical personnel at various levels in the organization.
  • Able to adapt to changing environments by using problem solving, analytical and team building skills.
  • Knowledge of Windows based PC environment.
  • Proficient with MS Office Suite – Excel, Word, Access, Outlook, Visio and Microsoft SharePoint.
  • Prior health care experience preferred.
  • Effective communication skills both verbally and in writing
  • Understanding of the Lean/Six Sigma methodology is preferred.
  • Strong organizational skills.

To apply for this job email your details to apply-a2izngyyh352@applicantstack.com

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