Clinician Services Analyst Senior - Primary Care
Advocate Aurora Health
Job Level
Mid-LevelSenior
About the role
- Audit and review Behavioral Health claims to identify potential errors.
- Analyze data against payer policies, procedures, and regulatory requirements.
- Document findings clearly and professionally to support next steps.
- Recommend claim adjustments or recoveries when necessary.
- Collaborate with cross-functional teams to solve problems and drive improvements.
- Stay ahead of the curve on regulations, laws, and industry standards.
- Track and report audit findings, spotting trends and opportunities.
- Share expert knowledge to guide teams on Behavioral Health payment integrity issues.
- Meet EXL’s productivity and quality goals while maintaining compliance with HIPAA and other regulations.
Requirements
- Bachelor’s degree in healthcare administration, business, finance, or a related field.
- 3+ years in Behavioral Health services (mental health and substance use disorder treatment).
- Credentials (Preferred): CCS, RHIA, RHIT, CPC, RN, MSW.
- Strong understanding of Behavioral Health standards, payer policies, and regulations.
- Bonus: Experience in Behavioral Health retrospective overpayment auditing.
- Ability to work independently in a fully remote environment.
- Strong time management and prioritization skills.
- A problem-solving mindset and ownership of results.
- Excellent communication skills (both written and verbal).
- Sharp analytical skills and great attention to detail.
- Proficiency in Microsoft Excel, Word, and OneNote.
- A passion for Behavioral Health auditing and a desire to thrive in a culture built on teamwork, collaboration, and excellence.
