Optimization/Recovery Reconciliation Analyst
Eskenazi Health

Indianapolis, Indiana

Posted in Medical and Nursing

Job Info

Division:Eskenazi Health


Req ID:13528

Schedule:Full Time


Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County. Physicians provide a comprehensive range of primary and specialty care services at the 327-bed hospital and outpatient facilities both on and off of the Eskenazi Health downtown campus as well as at 10 Eskenazi Health Center sites located throughout Indianapolis.

FLSA Status


Job Role Summary

The Behavioral Health Optimization/Reconciliation Analyst assists in the development, implementation, and training related to all DARMHA, Core Report, Professional Billing and MRO optimization and reconciliation tools to enable clinical leadership to monitor DARMHA, Core Report, Professional Billing and MRO usage both timely and effectively. This position works collaboratively with The Director of Operations and Director of Clinical Services to ensure accurate and compliant data analysis for all Sandra Eskenazi Mental Health Center (SEMHC) areas.

Essential Functions and Responsibilities

  • Assists in the development, implementation, and training related to all DARHMA, Core Report, Professional Billing and MRO optimization and reconciliation tools to enable clinical leadership to monitor and manage these both timely and effectively
  • Independently creates reviews, updates data and reports from various sources including DARMHA, Medicaid, and other internal sources to validate and update data, including, but not limited to:
    • Missing diagnosis
    • Invalid RID (Medicaid Recipient ID#)
    • Incorrect or missing Medical Record # in DARMHA
    • Clients with/without and MRO Package and any associated explanations
    • Missing/incorrect DOB (date of birth)
    • NOMS data in DARMHA
    • HAP Status
    • Missing/overdue assessment data
    • Multiple open episodes
    • Other data/reports as needed
  • Assists staff and supervisors with questions regarding clients MRO packages, eligibility, and billing when needed
  • Ensures follow-up occurs on a timely basis to support appropriate process, quality, and reimbursement
  • Designs custom reports and documentation; utilizing appropriate software application
  • Identifies and determines data trends and communicates this information on a routine basis to administrative staff, clinical managers and supervisors.
  • Collaborates with Eskenazi Health Epic Teams, Informatics Teams, and other data system teams to synthesize data collection, analysis, run reports and ensures.
  • Serves as a resource to the Senior Leadership of Sandra Eskenazi Mental Health Center by assisting in special projects. Such projects include, but are not limited to:
    • Developing project documentation and communication for each project assigned including, but not limited to, project charters, project plans, timelines and status reports.
    • Coordination and scheduling of resources in support of project implementation
    • Ensuring projects adhere to the disciplines of risk, issue, communication and charge management
    • Working with inter-organizational resources to ensure project tasks are completed on schedule
    • Evaluating project scope and requirements against stated objectives from stakeholders, ensuring that the project is scoped appropriately to meet objectives

Job Requirements

  • Bachelor of Science Degree in healthcare, finance, business, or related field required.
  • 2 years' experience directly related to optimization, billing, reconciliation, and training preferably in a healthcare setting preferred.

Knowledge, Skills & Abilities

  • Excellent oral and written communication skills. Must be able to effectively interact and present information with clinical and non-clinical staff
  • Excellent customer service and organizational skills, detail and task oriented, effectively manages time and workload, and sets appropriate priorities
  • Excellent data analysis skills, proficiency in Microsoft Office and database functions
  • Demonstrates team oriented, professional conduct when resolving issues with internal and external customers
  • Possess strong organizational detail oriented skills and work efficiently in a multi-task environment

Accredited by The Joint Commission and named one of the nation's 150 best places to work by Becker's Hospital Review for four consecutive years and Forbes list of best places to work for women, and Forbes list of America's best midsize employers' Eskenazi Health's programs have received national recognition while also offering new health care opportunities to the local community. As the sponsoring hospital for Indianapolis Emergency Medical Services, the city's primary EMS provider, Eskenazi Health is also home to the first adult Level I trauma center in Indiana, the only verified adult burn center in Indiana, the first community mental health center in Indiana and the Eskenazi Health Center Primary Care - Center of Excellence in Women's Health, just to name a few.

Nearest Major Market: Indianapolis

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