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Systems Analyst

2 months ago

New York, United States NYC Health Hospitals Full time

Elmhurst Hospital Center (EHC) is the major tertiary care provider in the borough of Queens. The hospital is comprised of 545 beds and is a Level I Trauma Center, an Emergency Heart Care Station and a 911 Receiving Hospital. It is the premiere health care organization for key areas such as Surgery, Cardiology, Women's Health, Pediatrics, Rehabilitation Medicine, Renal and Mental Health Services.

At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception. Every employee takes a person-centered approach that exemplifies the ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence) through empathic communication and partnerships between all persons.

Work Shifts

8:00 A.M - 4:00 P.M

Job Description

A member of the revenue cycle process, the Systems Analyst, is responsible for supporting the Patient Accounts Department in planning, designing & evaluating activities.The Systems Analyst participates in project implementation through research, analysis & follow-up activities & other appropriate duties, as assigned. The Systems reports to the Assistant Coordinating Manager.

Duties & Responsibilities
•Maintains IPRO/ESMSEF Mailgate Portal for Elmhurst IPRO Medicaid Cost Outlier correspondences, reroutes emails to appropriate staff, processes all incoming IPRO/ESMSEF correspondence: Technical Denials, DRGs, Predenial, Final, Utilization Reviews, Determinations, Approvals & all other correspondences related to Medicaid Cost Outlier cases & uploads all Hospital responses to IPRO/ESMSEF Mailgate portal & communicates to supervisor portal issues.
•Process all Medicaid Cost Outlier correspondence related to: Technical Denial, Initial Request, Appeal/UR/DRG Determination, Approval, Predenial, Final, Waiver & uploads all Hospital responses to Medicaid Cost Outlier denials to IPRO/ESMSEF Mailgate portal.
•Lead on Medicaid Cost Outlier DRG workflow, processing correspondence, communicating with HIM & staff & uploads Hospital DRG correspondence to IPRO/ESMSEF.
•Prepares responses, identifies findings & issues for the Medicaid Cost Outlier appeals process under the guidance of the Principal Hospital Care Investigator & the Assistant Coordinating Manager & assists with reports from Central Office.
•Performs data entry in the Medicaid Cost Outlier Access Database & Epic H2O, creates reports, communicates issues & maintains wellness of database, uploads to OnBase & updates Access Database & Epic H2O.
•Support administrative workflow in receiving, processing & managing responses to CMS Medicare RAC Performant denials & communicating with staff, checks Performant portal & communicates with Supervisor any issues.
•Prints eMedNY paper form 150003, relates to Supervisor any issues.
•Apply quantitative research & collect, classify, analyze & summarize data; prepare recommendations concerning assigned projects.
•Perform research & other information gathering activities & prepare these materials for input into reports for sharing & review at team meetings.
•Prepare drafts of reports, memorandums & other correspondence dealing with planning on assigned projects.
•Attend all necessary training sessions to effectively perform the day-to-day functions of the position.
•Participate & support projects identified by Assistant Coordinating Manager and Principal Hospital Care Investigator in the support of the Patient Accounts Department's Medicaid Billing & Follow Up Unit.

Minimum Qualifications
1. A Baccalaureate Degree in Industrial Engineering, Systems, Industrial Management, Business Administration or related fields; or,
2. Two years of technical training or education beyond the High School level with a minimum of two years of full-time, paid experience in the field of industrial engineering, systems analysis, methods and procedures, work simplification, cost reductions, EDP data processing applications, forms design and control; or,
3. A satisfactory combination of the above

Department Preferences

EDUCATIONAL LEVEL:

  • A Baccalaureate Degree from an accredited college or university in Business Administration., Engineering or Social Science, Health Care Specialization, Physical Sciences or related program; or
  • High School graduate with four years of experience related to Health Care Program Planning, Research, Design, Operation, Evaluation and Analysis
KNOWLEDGEABLE IN:
  • Basics of Hospital's Revenue Cycle & general principles of hospital's billing & follow-up requirements.
PREFERRED SKILLS:
  • Strong communication skills (written & oral);
  • Strong time management skills;
  • Computer literate;
  • Prior experience working within electronic medical record & financial management system in hospital or physician office setting
EQUIPMENT/MACHINES OPERATED:
  • Desktop PC; laptop; scanner, all-in-one (printer/scanner/fax)
COMPUTER PROGRAMS/SOFTWARE OPERATED:
  • EPIC EMR & Financial Management System
  • On-Base & Media Manager for Scanning
  • Secure Payer Portals (e.g. Mailgate for IPRO)
  • MS Excel, Word, Access, PowerPoint
  • Adobe Acrobat
YEARS OF EXPERIENCE:
  • Satisfactory combination of education, training & experience.
If you wish to apply for this position, please apply online at employment.nychhc.org.

NYC Health and Hospitals offers a competitive benefits package that includes:
  • Comprehensive Health Benefits for employees hired to work 20+ hrs. per week
  • Retirement Savings and Pension Plans
  • Loan Forgiveness Programs for eligible employees
  • Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts
  • College tuition discounts and professional development opportunities
  • Multiple employee discounts programs