At Boston Children's Hospital, success is measured in patients treated, parents comforted and teams taught. It's in discoveries made, processes perfected, and technology advanced. In major medical breakthroughs and small acts of kindness. And in colleagues who have your back and patients who have your heart. As a teaching hospital of Harvard Medical School, our reach is global and our impact is profound. Join our acclaimed Billing Compliance Department and discover how your talents can change lives. Yours included.
The Compliance Data Analyst I will be responsible for:
Compiling data based on parameters identified for billing compliance audit. Data may need to be obtained through various source systems.
Ensuring that data is verified for validity prior to building audits.
Meeting with Billing Compliance team to explain the findings of the data analyses so that the team may make an informed decision on the audit scope, including any potential confounding factors as identified through data analysis.
Assisting with reporting of data and dissemination of reports.
Maintaining source systems that houses data and serves as the technical lead on the data warehouse to both the Billing Compliance team and the external vendor.
As needed, under general supervision, performing audits of clinical documentation, hospital billing and payment records and applicable industry standard billing codes to determine if the billed coding is substantiated by medical record documentation. Working collaboratively with applicable Hospital Departments to identify and recommend strategies for process improvement based on audit findings. Assisting in response to billing audit requests from outside the institution (e.g., government audits, payer audits) as needed.
To qualify, you must have:
The knowledge of either data analytics or prior work experience in healthcare.
The analytical skills to collect information from diverse sources, apply professional principles in performing various analyses, and summarize the information and data in order to build audits in the selected system Compliance utilizes.
An Associate's degree is required and a Bachelor's degree is preferred, with 1 year experience in health care coding.
Coding Certification helpful, however not required.
Excellent communication skills and the ability to work in a team environment.
Boston Children's Hospital offers competitive compensation and unmatched benefits, including an affordable health, vision and dental insurance, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition Reimbursement, and discounted rates on T-passes (50% off). Discover your best.
Boston Children's Hospital is an Equal Opportunity / Affirmative Action Employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, sex, sexual orientation, gender identity, protected veteran status or disability.
Internal Number: 3037376
About Boston Children's Hospital
Boston Children's Hospital is a 395-bed comprehensive center for pediatric health care. As one of the largest pediatric medical centers in the United States, Children's offers a complete range of health care services for children from birth through 21 years of age.