Qureos Mentor

Community Care Cooperative

<p></p><div><p><b>Title</b>: Epic Analyst I, Professional Billing &amp; Claims
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<b>Reports to</b>: Manager of Professional Billing and Claims
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<b>Classification</b>: Individual Contributor<br>
<b>Location</b>: Boston (Hybrid)<br>
<b>Job description revision number and date</b>: V: 3.0; 11.3.2025</p><p><br>
Organization Summary:<br>
Community Care Cooperative (C3) is a 501(c)(3) non-profit, Accountable Care Organization (ACO) governed by Federally Quality Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast-growing organization founded in 2016 with 9 health centers and now serving 150,000 Medicaid beneficiaries who receive primary care at 18 health centers across Massachusetts. We are an innovative organization developing new partnerships and programs to improve the health of members and communities and to strengthen our health center partners.</p><p><br>
Job Summary:<br>
The Professional Billing Claims Analyst II position will be housed under a new subsidiary organization of C3, Community Technology Cooperative, LLC (CTC). To implement, maintain, support, and maximize the use of clinical, financial, and administrative portions of the software applications utilized by CTC in conducting daily operations under the direction of the Manager of Professional Billing and Claims. This includes:</p><div><ul><li><br>
Maintaining current clinical, financial, and administrative applications, implementing new clinical, financial, and administrative applications</li><li>Assisting in the assessment of workflow processes and assisting in process re-engineering to achieve efficiencies in departmental operations</li><li>Assisting users in developing reports and analyses, troubleshooting, and resolution of application issues</li><li>Working with the IT Education staff to assist in training users and in the development of documentation</li><li>Maintaining a level of knowledge about IT operations and network issues and maintaining current industry knowledge</li></ul></div><div><br>
Responsibilities:<br>
<ul><li>Ability to maintain current system applications</li><li>Facilitate end users&rsquo; ability to understand and maximize the use of the software to perform daily operations</li><li>Evaluate user knowledge and work with IT education staff to develop specialized training when necessary; educate users in system optimization</li><li>Acts as liaison between users and the software vendor(s)</li><li>Guides the modification of system applications in instances where current applications impede performance or where changes will enhance performance</li><li>Ensure system application updates are working properly before updates are loaded into the live system by coordinating testing and update dates with users and vendors</li><li>Integrate new application(s) in the existing HIS according to the implementation schedule</li><li>Respond to user questions with timely answers and/or referral to appropriate department/person</li><li>Assist users with technical problems by alerting HIS Operations staff to the need for repair or investigation</li><li>Coordinate with Database Analysts to provide expertise in the development of reports and analyses</li><li>Work with other IT staff to ensure interfaces between applications and systems are functioning properly</li><li>Maintain and periodically review dictionaries, assist in entering and maintaining user codes, maintain the security of applications, and ensure consistency between various dictionaries</li><li>Investigate on timely basis discrepancies in statistics which could indicate a problem with the accuracy of data</li><li>Work with application managers, staff from affected areas, and representatives from other impacted areas, to analyze computer system functions and compare data and existing systems both functionally and procedurally</li><li>Implement new clinical, financial, and administrative software, including add-on features, and/or new routines in existing applications</li><li>Participates with other IT staff and other clinical, financial, and administrative areas in the planning and implementation stages of the application, including the development of dictionaries</li><li>Work with Department Managers and IT Education staff to ensure training programs for use of applications are developed and conducted for all levels of users and participate in such programs when needed</li><li>Develop system documentation to supplement vendor manuals and which defines processes, procedures, and policies regarding utilization of various functions</li><li>Assist departments with the development of downtime procedures</li><li>Work with Operation Manager and staff to establish schedules for report production and system jobs to maintain balanced system utilization and minimize system degradation, if necessary</li><li>Sustain working knowledge of key functions of all aspects of the department in order to provide emergency coverage in the absence of others in the department</li><li>Work with Applications Manager to accomplish other departmental tasks</li><li>Notify the Applications Manager of requests for custom modifications to standard applications and of any updates to standard systems which replace existing custom modifications so that the Application Manager can take appropriate action</li><li>Assist in the development of IT policies and procedures and notify users as appropriate</li><li>Participate in applications on-call rotation for the information system</li><li>Participate in workgroups and committees as necessary</li><li>Demonstrates competent and effective job performance skills as evidenced by the volume, skill, and technical knowledge of work performed, neatness, accuracy, thoroughness, and completeness, and the ability to follow instructions</li><li>Strong attention to detail</li><li>Ability to manage multiple priorities in an effective and organized manner</li><li>Demonstrates the ability to interact effectively and in a professional manner with peers</li></ul>
Administration, and other customers as demonstrated by willingness to work with others to achieve CTC&rsquo;s goals<br>
<ul><li>Ability to present a friendly and positive manner, willingness to seek additional tasks</li><li>Responsibility to assist the department and/or peers, ability to be flexible and perform new tasks and adjust to change even under pressure</li><li>Ability to accomplish results by working effectively with or through other people</li><li>Ability to hear and communicate with others in a clear, understandable, and professional manner in person and on the phone</li><li>Ability and commitment to provide outstanding customer service</li><li>Ability to actively listen, demonstrate patience and empathy, and authentically engage with individuals in a caring and helpful manner</li><li>Ability to identify and resolve problems and maintain composure and sound judgment in difficult or stressful situations</li><li>Maintain current industry knowledge by attending industry seminars, reviewing professional literature, and communicating on a regular basis with other IT analysts</li><li>Required to travel onsite for site visits and project milestones either at the health center or the CTC office in Boston</li></ul></div><p></p><div><br>
Required Skills:<br>
<ul><li>Ability to understand, analyze, document, and explain business processes and the data that underly them</li><li>Experience working with Electronic Health Records, medical claims, and other health care data</li><li>Experience working with Clearinghouses to facilitate claims transmission preferred</li><li>Flexible and adaptable to change in a fast-paced environment</li><li>Demonstrated ability to work both independently and as part of a team</li><li>Demonstrated ability to thrive in a fast-past environment</li><li>Nuanced interpersonal communication skills</li><li>Weekly on-call will be a requirement for this position</li></ul></div><p></p><div><br>
Desired Other Skills:<br>
<ul><li>Familiarity with the MassHealth ACO program</li><li>Familiarity with Federally Qualified Health Centers</li><li>Experience working in a provider organization</li><li>Experience working in a managed care environment</li><li>Experience with anti-racism activities, and/or lived experience with racism is highly preferred</li></ul></div><p></p><div><br>
Qualifications:<br>
<ul><li>Bachelor&rsquo;s degree in a healthcare-related field, Information Systems or Business Management</li><li>Resolute Professional Billing Claims Administration and Electronic Remittance certification preferred, but not required</li><li>0-1 years of healthcare or Epic experience</li><li>Prior EHR support experience preferred, but not required</li></ul></div><p><b><i><br>
** In compliance with Infection Control practices per Mass.gov recommendations, we require all employees to be vaccinated consistent with applicable law. **</i></b></p></div>

Analyst I, Professional Billing & Claims

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Analyst I, Professional Billing & Claims