Assistant Administrative Analyst - Provider Enrollment - FT Days

University-of-California,-Irvin; Orange (CA); On-site; USD 85,000 - 115,000; Full time

Job summary

UCI Health seeks a Provider Data Analyst to maintain the database for hospital, group and billing providers and to prepare rosters and enrollment reports that meet regulatory requirements.

You will ensure data accuracy, collaborate with billing to resolve enrollment/credentialing issues, and support management in pursuing productivity and process improvement goals for the department.

Qualifications

• Proficiency in database, spreadsheet and presentation software.
• Minimum of 5 years of relevant experience.
• Excellent written and verbal communication skills in English.
• Bachelor's Degree in related area and/or equivalent education/experience.
• Advanced knowledge of healthcare regulations and managed care.
• Advanced knowledge of provider enrollment / credentialing and medical staff operations.
• Advanced ability to maintain confidentiality and handle sensitive information.
• Strong ability to communicate complex clinical finance information clearly.
• Ability to interact with all levels of medical staff and leadership.

Responsibilities

• Maintain the database for hospital, group and billing providers and prepare rosters and enrollments reports.
• Review data for accuracy and support billing in enrollment/credentialing matters.
• Assist management in achieving productivity and process improvement goals.

Skills

Database proficiency

Spreadsheet skills

Presentation software

Communication skills

English proficiency

Time management

Analytical thinking

Confidentiality

Relationship building

Education

Bachelor's degree in related area

Tools

MS Office

EMR systems

Credentialing software

Microsoft Access

Job description

Who We Are

UCI Health is one of California's largest academic health systems and the clinical enterprise of the University of California, Irvine. Established on July 1, 1976, UCI Health has grown into a 1,461-bed health system that includes UCI Health - Orange, UCI Health - Irvine, four Community Network hospitals and a growing network of ambulatory care centers across Orange and Los Angeles counties. As Orange County’s only academic health systems, UCI Health is home to the only National Cancer Institute-designated comprehensive cancer center based in the county, the region’s only American College of Surgeons-verified Level I adult and Level II pediatric trauma center, American College of Emergency Physicians Gold Level 1 Geriatric Emergency Department and a nationally recognized regional burn center verified by the American Burn Association. Powered by UC Irvine, UCI Health serves 5.6 million people across Orange County, western Riverside County and southeast Los Angeles County through excellence in patient care, research and medical education.

Your Role on the Team

Position Summary

The Provider Data Analyst is responsible for maintaining the database for hospital, group and billing providers and prepares rosters and reports pertaining to quality, compliance, and enrollment. The Provider Data Analyst ensures accuracy of information and inclusion of all network providers. The Provider Data Analyst reviews and analyzes provider data to prepare provider rosters and enrollments report that meet regulatory requirements and third-party payor reporting criteria. The Provider Data Analyst works with billing departments / agents to ensure data integrity and researches claim denials related to provider enrollment / credentialing issues. The Provider Data Analyst assists management in achieving department productivity and process improvement goals.

What It Takes to be Successful

Required Qualifications

• Proficiency in common database, spreadsheet and presentation software.
• Must possess the skill, knowledge and ability essential to the successful performance of assigned duties
• Must demonstrate customer service skills appropriate to the job
• Minimum of 5 years of relevant experience
• Excellent written and verbal communication skills in English
• Detail oriented, with demonstrated organizational skills and the ability to manage time efficiently, prioritize tasks, set schedules, and complete projects in a timely and cost-effective manner.
• Demonstrated communications skills, with the ability to interpret and convey complex clinical finance information in a clear, concise manner. Ability to summarize and present reports and presentations.
• Demonstrated analytical and problem-solving skills, with the ability to evaluate the effectiveness of workflows and systems.
• Bachelor's Degree in related area and/or equivalent education/experience
• Advanced knowledge of relevant healthcare regulations issued by Federal and State entities.
• Advanced knowledge of managed care, provider enrollment / credentialing, and / or medical staff operations. Working knowledge of the practices, procedures, and concepts of the healthcare enrollment cycle. Knowledge of any or all the following: billing, collections, contracts.
• Advanced knowledge and skill using MS Office applications, EMR systems, and credentialing software. Ability to set priorities and lead performance improvement projects.
• Advanced communication, conflict-management, and customer-service skills.
• Advanced ability to organize and prioritize assignments and workload.
• Advanced ability to maintain confidentiality and use discretion when handling sensitive medical staff issues.
• Advanced ability to interact with all levels of medical staff, including department chairs, division chiefs, and medical staff providers.
• Ability to maintain a work pace appropriate to the workload
• Ability to interpret health plan enrollment regulations to ensure compliance.
• Ability to establish and maintain effective working relationships across the Health System

Preferred Qualifications

• SFTP working knowledge
• Proficiency in Microsoft Access
• Knowledge of University and medical center organizations, policies, procedures and forms
• Knowledge of MD-Staff software

Total Rewards

We offer a wealth of benefits to make working at UCI even more rewarding. These benefits may include medical insurance, sick and vacation time, retirement savings plans, and access to a number of discounts and perks. Please utilize the links listed here to learn more about our compensation practices and benefits.

Conditions of Employment

The University of California, Irvine (UCI) seeks to provide a safe and healthy environment for the entire UCI community. As part of this commitment, all applicants who accept an offer of employment must comply with the following conditions of employment:

• Background Check and Live Scan
• Employment Misconduct*
• Legal Right to Work in the United States
• Vaccination Policies
• Smoking and Tobacco Policy
• Drug Free Environment

Exercise the utmost discretion in managing sensitive information learned in the course of performing their duties. Sensitive information includes but is not limited to employee and student records, health and patient records, financial data, strategic plans, proprietary information, and any other sensitive or non-public information learned during the course and scope of employment. Understands that sensitive information should be shared on a limited basis and actively takes steps to limit access to sensitive information to individuals who have legitimate business need to know. Ensure that sensitive information is properly safeguarded. Follow all organizational policies and laws on data protection and privacy. This includes secure handling of physical and digital records and proper usage of IT systems to prevent data leaks. The unauthorized or improper disclosure of confidential work-related information obtained from any source on any work-related matter is a violation of these expectations.

*Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer.

The following additional conditions may apply, some of which are dependent upon business unit or job specific requirements.

• California Child Abuse and Neglect Reporting Act
• E-Verify
• Pre-Placement Health Evaluation

Details of each policy may be reviewed by visiting the following page: https://hr.uci.edu/new-hire/conditions-of-employment.php

Closing Statement

The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected categories covered by the UC Anti-Discrimination Policy. We are committed to attracting and retaining a diverse workforce along with honoring unique experiences, perspectives, and identities. Together, our community strives to create and maintain working and learning environments that are inclusive, equitable, and welcoming. UCI provides reasonable accommodations for applicants with disabilities upon request. For more information, please contact UCI's Employee Experience Center (EEC) at [e-mail] or at [phone], Monday - Friday from 8:30 a.m. - 5:00 p.m.

Consideration for Work Authorization Sponsorship

Must be able to provide proof of work authorization