Analyst

• Maintain and update enterprise-wide and department coding policies and procedures for PHS
• Monitor compliance to external regulatory agency coding rules and regulations
• Coordinate internal and external enterprise-wide coding audits across PHS
• Summarize and track internal and external audit results
• Coordinate and track enterprise-wide training for coding, audit, physician and clinician personnel
• Track corrective action plans for identified low performers
• Perform medical record and billing reviews of denied and appealed claims
• Compile and analyze enterprise-wide coding scorecard metrics for denials, appeals and coding accuracy
• Research regulatory agency regulations
• Correct patient accounts based on audit findings
• Liaise with Information Services, Finance/Patient Financial Services, hospitals, PMG sites, PHP, Home Health, Albuquerque Ambulance, Compliance and ancillary departments
• Maintain accurate, complete and timely documentation
• Maintain and disseminate current legal and regulatory information, including ICD-9, CPT-4, HCPCS and APC updates
• Research coding, billing and charging compliance issues and implement corrective action plans
• Respond to daily coding and auditing inquiries and perform ad-hoc analysis for PHS management
• Gather and analyze information and recommend solutions for business issues
• Respond to client inquiries by telephone and email
• Maintain working knowledge of PHS coding and auditing IT applications
• Investigate patient care and billing concerns
• Analyze and summarize medical record and account audit data and communicate findings to management
• Document inquiry responses and resolutions in information systems
• Assist with audit research and documentation

CDQA Administrative Analyst

• Review contract terms and conditions across T&M, FFP, FFP LOE, CPFF, and CPIF contracts
• Ensure compliance with financial clauses and contractual requirements throughout project implementation
• Maintain responsibility for product and service quality, cost control, timeliness, and business relations across awarded task orders
• Establish and maintain time-phased cost/schedule baselines and enforce change control
• Monitor status and availability and ensure proper work authorization
• Prepare manpower and non-labor forecasts and assist with resource planning
• Forecast, monitor, and update program revenue
• Identify resource gaps and work with business leadership to address them
• Assess contract performance and initiate corrective action as needed
• Coordinate customer-focused services with Government Contracting Officers, representatives, AV project managers, and subcontractor project managers
• Monitor functional manager performance and required reports, including CDRLs
• Resolve performance-related issues promptly
• Advise project managers, CAMs, and senior technical personnel on Earned Value Management procedures
• Assist with program setup, planning, and control, including tailored EVMS
• Monitor performance and provide variance analysis and project visibility
• Monitor contract value and CLINs for cost collection, reporting, and funding status
• Develop standard and ad hoc reports and recommendations for management decision-making
• Produce and validate IPMRs and similar customer and program management status reports
• Track subcontract costs and schedules, material receipts, open commitments, and termination liability
• Use MS Office Suite, Cobra, Unanet, and SharePoint
• Track and report material purchases, cost of goods sold, and revenue for commercial products/product lines
• Mentor and coach Program Control Analysts
• Perform other duties as assigned or required

Analyst jobs in New Mexico

CDQA Administrative Analyst

Senior Program Control Analyst