Medical Claims Analyst

Description The Claims Analyst will ct as liaison for clinicians as it pertains to clinical documentation and meeting county requirements.

Become familiar with the behind the scenes billing processes for client hours in order to be able to problem solve when clinician records and billing records do not match.

May be involved in completing and distributing monthly QA chart review notifications to clinicians.

Will conduct quality reviews of all case psychotherapy records (at the opening, 6 month, annual and closing reviews).

Will help to maintain and update the department record of reviews and completion of closed cases.

Participate in group trainings on Medi-Cal documentation, funding sources, and other documentation, billing, and QA policies.

May participate in the development and implementation of an Electronic Health Record system.

Facilitate with the transition to electronic health records, which may include participation in development meetings and tasks, training, maintenance, and ongoing electronic record reviews.

May be expected to attend weekly and off-site county meetings on QA-related topics.

May be responsible for tracking and organizing transfer of charts between archive storage and administration office.

Will perform other duties or projects as assigned by the QA Manager.

Requirements

Master's degree, license or license eligible clinician

A minimum of two years providing psychotherapeutic services

A minimum of two years experience with Medi-Cal documentation requirements and a record of good charting habits

Ability to quickly learn other state and county charting requirements

Well organized, flexible, and able to manage multiple priorities and shifting deadlines

Must have the ability to work independently as well within a team environment

Must be detail oriented

Excellent verbal and written communication skills

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