Chenega Corporation Functional Area Analyst-Middle in Aurora, Colorado
AMERICAN HOSPITAL SERVICES GROUP LLC]
Company Job Title: Functional Area Analyst-Middle
Chenega Job Title: Paralegal/Legal Assistant III
Clearance: Background Check
Location: Aurora, CO
Reports To: On-Site Program Manager
FLSA Status: Non-Exempt, Full Time, Regular
Prepared Date: 10-10-2019
Approved Date: 03-26-2019
- The Functional Area Analyst – Middle will perform duties including but not limited to; QA audits on selected claims to ensure external audit accuracy. Organizes materials, develops briefings, disseminates reports, maintains audit schedules, and tracks timelines related to all quarterly and annual claims audits; performs ad hoc analysis of claims data including but not limited to error code trending analysis, data analytics and data mining; validates recoupment data provided by healthcare delivery contractors. Conducts research pertaining to ongoing and past claims audits for Contracting Officers and other DHA personnel as needed. This position is in support of the Defense Health Agency (DHA) Program Management Support Services contract.
Duties and Responsibilities:
Assists with the development of improper payment reports and provides meeting and analytical support
Conducts focused studies; drafts correspondence requesting clarification of TRICARE policy language
Conducts and interprets qualitative and quantitative analysis of data
Prepares documentation for healthcare contractor reviews
Other duties as assigned
Minimum Qualifications: (To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.)
Bachelor’s degree from an accredited college in a related discipline, or equivalent experience/combined education, with a minimum of five (5) years professional experience
Minimum of five (5) years demonstrated work experience.
Ability to obtain an Public Trust (NACI) security clearance
Knowledge, Skills and Abilities:
List of KSA for each position Be able to effectively communicate orally and in writing.
Functional knowledge of Microsoft Access, Word, Excel, PowerPoint, Outlook and Windows-based operating systems is required.
Must be well organized and be able to manage numerous, simultaneous activities.
Strong MS Office application skills (advanced knowledge of Excel and/or Access), data mining and analytical experience; and research skills; excellent organizational skills, effective communication and writing skills; ability to produce complex reports and formalize conclusions and trends; ability to manage multiple tasks and timelines.
Claims auditing, claim processing, medical coding and/or billing experience, International Classification of Diseases Ninth Revision (ICD-9), ICD-10, TRICARE experience; statistical experience. Security Clearance ADPII as required by the DOD.
Strong working knowledge of HCPCs, ICD-9 & 10, and CPT’s
Claims experience with TRICARE (working knowledge of) is preferred but not required.
Physical Demands: (The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.)
- While performing the duties of this Job, the employee is regularly required to sit and talk or hear. The employee is frequently required to walk; use hands to finger, handle, or feel and reach with hands and arms. The employee is occasionally required to stand; climb or balance and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision.
Work Environment: (The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.)
The employee will normally work in a temperature-controlled office environment, with frequent exposure to electronic office equipment.
During visits to areas of operations, may be exposed to extreme cold or hot weather conditions. Is occasionally exposed to fumes or airborne particles, toxic or caustic chemicals, and loud noise.
Chenega Corporation and family of companies is an EOE.
Equal Opportunity Employer/Veterans/Disabled
Native preference under PL 93-638.
We participate in the E-Verify Employment Verification Program.
Primary Location: United States-Colorado-Aurora
Organization: American Hospital Services Group (AHSG)
Strategic Business Unit: Environmental Healthcare and Facilities
Security Requirements: Background Check
Job Schedule: Full Time Non-Exempt
Recruiter: Cathleen Stewart
Req ID: 1900004099
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