Management Analyst 4

Job Summary:

This position is responsible for the supervision and evaluation of data processing and data quality assurance activities for the Federally funded National Breast and Cervical Cancer Screening Program (NBCCEDP) through the Well Woman HealthCheck Program (WWHP). The position is responsible for supervising data processes and conducting continuous quality improvement (CQI) to ensure optimal performance, data integrity, and efficiency. The position will lead and conduct data quality analyses routinely, present recommendations to management, provide technical assistance or consultation, and coordinate process improvements and systems implementation. This position will develop or update data entry manuals outlining established methods of performing work, provide quality control for all data entered in CaST, and provide training and support to other data analysts. Lastly, they will ensure data entry error rate is at or below .01%, respond to questions and concerns from other data analysts, lead weekly huddles, and present at quarterly meetings with contractors.
Additionally, the position will do the following:
-Review assigned codes to diagnoses and procedures, using program approved CPT (Current Procedural Terminology) codes
-Ensure codes are accurate and sequenced correctly in accordance with NBCCEDP and Medicare regulations
-Follow up with the clinic coordinators on any documentation that is insufficient or unclear
-Communicate with other contracted clinical staff regarding documentation
-Search for information in cases where the coding is complex or unusual
-Review patient records and patient listing spreadsheet for accuracy
-Participate in quality assurance and utilization review as needed
-Provide ongoing train of new team members via google meet & in person to include designing and coordinating onboarding training
packet, SOW, CPT code, CaST guidance manual etc.
- Provide Quality Control for the review and data entry process

Job Duties:

Review and audit claims submitted by contractor participating in the Well Woman HealthCheck Program (WWHP). Reviews patient medical record/ documentation submitted for accuracy and analyzes work processes and makes recommendations for process improvement. Serve as designated quality control personnel for the WWHP.

Investigate medical procedure codes billed to ensure compliance with NBCCEDP Policy and procedures and the State of Arizona WWHP Scope of Work. Conduct effectiveness reviews to ensure only program approved codes are used and communicate effectively with providers and other clinical staff regarding insufficient or unclear documentation.

Deny/Approve or correct codes based on medical documentation provided. Engage contractors for clarification, missing documentation. Develop or update functional or operational manuals outlining established methods of performing work in accordance with WWHP policy.

Ensure codes are accurate and sequenced correctly. Research coding for complex or unusual cases. Troubleshoot difficult cases and coding scenarios with WWHP Program Manager, Cancer Program Administrator and Epidemiologist for best decision making.

Ensure accuracy in data entry and review process by conducting daily continuous quality improvement (CQI) of data entry process. Train and support team members as needed and participate in weekly huddle for program and quarterly contractor meetings as a presenter.

Other duties as assigned as related to the position (typically 5% - 10%)

Knowledge, Skills & Abilities (KSAs):

Knowledge of:
- Medical billing and coding education/
training.
- CPT (Current Procedural Terminology) codes and Medicare regulations.
- Working knowledge of CMS Medicaid &
Medicare authorized billing codes.
- Strong understanding of Microsoft Excel
and working with adobe PDF files.

- Performance Management (PM), and Continuous Quality Improvement (CQI) and Lean methodologies.

Skill in:
- Reviewing and entering data into a
specialized system.
- Setting up, manipulating, and editing documents.
- Identify problems and determine effective
solutions.
- Excellent typing and transcription skills,
with speed and accuracy.
- Presenting information on a statewide level.
- Must have understanding of medical terminology.
- Data entry protocols and techniques.
- Document archiving procedures.

Ability to:
- Exhibit excellent communication Skills
including verbal and written.
- Conduct basic research and collect
data.
- Accuracy and attention to detail.
- Organizational and time-management Skills.
- Problem solve independently
- Learn a new systems and concepts quickly.
- Read and understand the program manual and scope of work
- Multitask, manage task, and project prioritization.
- Effective communication skills.
- Work under pressure & problem solve creatively.
- Supervised and manage processes.

- Support a diverse multi-cultural workforce that reflects the community, promotes equal opportunity at all levels of public employment, and creates an inclusive work environment that enables all individuals to perform to their fullest potential free from discrimination.

Selective Preference(s):

Associates or Bachelors degree in Allied Health Science, Certified Medical Billing and Coding and 3 years experience working as a medical biller/coder. Preference given to candidates with a Medical Billing and Coding Certification.

Pre-Employment Requirements:

None.

If this position requires driving or the use of a vehicle as an essential function of the job to conduct State business, then the following requirements apply:

All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify).

Benefits:

The State of Arizona provides an excellent comprehensive benefits package including:
− Affordable medical and dental insurance plans
− Paid vacation and sick time
− Paid Parental Leave-Up to 12 weeks per year paid leave for newborn or newly-placed foster/adopted child (pilot program).
− 10 paid holidays per year
− Wellness program and plans
− Life insurance
− Short/long-term disability insurance
− Defined retirement plan
− Award winning Infant at Work program
− Credit union membership
− Transit subsidy
− ADHS Student Assistance Pilot Program

By providing the option of a full-time or part-time remote work schedule, employees enjoy improved work/life balance, report higher job satisfaction, and are more productive. Remote work is a management option and not an employee entitlement or right. An agency may terminate a remote work agreement at its discretion.

Learn more about the Paid Parental Leave pilot program . For a complete list of benefits provided by The State of Arizona, please visit our

Retirement:

To help you build a financially secure future, the State makes monthly contributions to finance your retirement benefit. The State will contribute to the ASRS in an amount equal to your contribution. In other words, you and the State will each pay 50% of the total cost of the benefit. New State employees have a 27-week wait period for contributions to begin.