Who We Are
UCI Health is one of California's largest academic health systems and the clinical enterprise of the University of California, Irvine. Established on July 1, 1976, UCI Health has grown into a 1,461-bed health system that includes UCI Health - Orange, UCI Health - Irvine, four Community Network hospitals and a growing network of ambulatory care centers across Orange and Los Angeles counties.
Your Role on the Team
Position Summary
The Provider Data Analyst is responsible for maintaining the database for hospital, group and billing providers and prepares rosters and reports pertaining to quality, compliance, and enrollment. The Provider Data Analyst ensures accuracy of information and inclusion of all network providers. The Provider Data Analyst reviews and analyzes provider data to prepare provider rosters and enrollments report that meet regulatory requirements and third-party payor reporting criteria.
The Provider Data Analyst works with billing departments / agents to ensure data integrity and researches claim denials related to provider enrollment / credentialing issues. The Provider Data Analyst assists management in achieving department productivity and process improvement goals.
What It Takes to be Successful
Required Qualifications
Proficiency in common database, spreadsheet and presentation software.
Must possess the skill, knowledge and ability essential to the successful performance of assigned duties
Must demonstrate customer service skills appropriate to the job
Minimum of 5 years of relevant experience
Excellent written and verbal communication skills in English
Detail oriented, with demonstrated organizational skills and the ability to manage time efficiently, prioritize tasks, set schedules, and complete projects in a timely and cost-effective manner.
Demonstrated communications skills, with the ability to interpret and convey complex clinical finance information in a clear, concise manner. Ability to summarize and present reports and presentations.
Demonstrated analytical and problem-solving skills, with the ability to evaluate the effectiveness of workflows and systems.
Bachelor's Degree in related area and/or equivalent education/experience
Advanced knowledge of relevant healthcare regulations issued by Federal and State entities.
Advanced knowledge of managed care, provider enrollment / credentialing, and / or medical staff operations. Working knowledge of the practices, procedures, and concepts of the healthcare enrollment cycle. Knowledge of any or all the following: billing, collections, contracts.
Advanced knowledge and skill using MS Office applications, EMR systems, and credentialing software. Ability to set priorities and lead performance improvement projects.
Advanced communication, conflict-management, and customer-service skills.
Advanced ability to organize and prioritize assignments and workload.
Advanced ability to maintain confidentiality and use discretion when handling sensitive medical staff issues.
Advanced ability to interact with all levels of medical staff, including department chairs, division chiefs, and medical staff providers.
Ability to maintain a work pace appropriate to the workload
Ability to interpret health plan enrollment regulations to ensure compliance.
Ability to establish and maintain effective working relationships across the Health System
Preferred Qualifications
- SFTP working knowledge
- Proficiency in Microsoft Access
- Knowledge of University and medical center organizations, policies, procedures and forms
- Knowledge of MD-Staff software
Job description provided by University of California, Irvine.
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