POSITION SUMMARY: The BH Documentation Compliance/Data Analyst is responsible for reviewing and analyzing behavioral health data to support policy, programs and service. This includes monitoring and, as necessary, coordinating the correction of clinical documentation for strict Medicaid, private insurance, and grant compliance. Supports compliance and risk management.
(Responsibilities, Accountabilities, and Competencies; May not include all duties of this position)
- Medicaid Compliance of Clinical Documentation: Reviews current consumer records to assess and ensure that service documentation is compliant with Medicaid and related regulations. Assists managers, supervisors and teams in developing, implementing and tracking documentation and demonstrating correction and improvement where indicated. Conducts special studies and audits as requested.
- Data Analysis: Collects and analyzes data from program activity for routine and ad hoc reporting in areas such as service utilization, staff productivity, & regulatory compliance.
- Data Integrity: Audits system data and communicates with Behavioral Health team to assist them with questions on proper entering of data into client record systems to maximize reporting functions.
- System Support: Works with IT and Behavioral Health teams on the research and implementation of electronic healthcare system changes / improvements.
- Training: Identifies training needs related to correct and complete documentation, reports to the individual supervisors and follows up to see that training is completed.
- Audit Support: Coordinates site review materials and activities.
- Provides back-up support to Front Desk/Scheduler and Records Clerk positions.
- Performs other related duties as assigned.
MINIMUM JOB QUALIFICATIONS:
(Any Equivalent Combination of Knowledge, Skills, Abilities, Education and Experience.)
- Education: Bachelor’s Degree
- A strong working knowledge of behavioral health billing and regulations – Minimum of two years’ experience providing and/or reviewing Medicaid reimbursable services.
- IT proficiency including expert MS Excel skills and database experience. – Minimum of three years’ experience manipulating data and reporting results.
- Critical thinking and strong data analysis skills and knowledge-based toolsets.
- Works and communicates with internal and external clients and customers to meet their needs in a polite, courteous and cooperative manner. Committed to quality service. Displays high standards of ethical conduct.
- Must be able to read and understand, Alaska Administrative Code, Medicaid Regulations, and other State and Federal standards, policies and regulations.
- Must be able to audit clinical records for compliance with State policy and interact and elicit change from clinical staff in a supportive and productive manner.
- Ability to use a personal computer and various types of word processing, spreadsheet, database and presentation software. Ability to graphically represent data, trends and conclusions.
- Ability to develop, monitor and assess performance goals, measures and targets, benchmarks, and program priorities.
- Ability to analyze and see trends in various types of data and recommend follow up steps in response to conclusions reached.
- Ability to work with diverse types of individual and opinions to arrive at consensus to change and improvement current practice, procedures and outcomes.
- Skill in compiling information, preparing accurate reports and maintaining accurate work related records.
- Knowledge of a wide range of mental health/substance abuse billing procedures and coding preferred.
- Licensure/Certification: none
- Other: TB test, pre-employment drug/alcohol screening, criminal background check.