Clinical Systems Specialist

Description:
This is an aggressive position that allows for interdepartmental expertise in working with the System Administration to develop various system applications, problem solve software issues, and evaluate/update workflows to meet changes that occur as needs evolve. He/she will develop and maintain security and confidentiality standards, as well as internal systems for compliance and reporting requirements. This professional is also responsible for coordinating reports and customer/technical interfaces. Focus is placed on continual improvement in the delivery of service to APS customers, both internal and external and compliance with governmental and other applicable standards.APS Healthcare employees are expected to maintain a positive work atmosphere through communicating and behaving in a manner that is courteous and respectful of customers, clients, co-workers, and supervisors. Creates reports utilizing the appropriate data management systems Serves as technical liaison with IS staff for system development and implementation of new and existing business Participates in implementation of new products and contracts and ensures departmental communication Performs System Administrator functions. (e.g. sets up letter templates, loads benefits in system, downloads eligibility files, and creates new users) Performs daily, weekly and monthly eligibility imports of member, providers and facilities Performs daily authorization extracts for customers Runs system reports, requests information to update reports, and provides report-building input. Generates additional reports as needed Maintains thorough working knowledge of all products and data management systems as identified and assigned Participates, as an active member on teams, committees, and other organization needs as identified and assigned Assists in the coordination of services for major customers Responsible for the troubleshooting of technical problems Facilitates service delivery and quality by actively seeking to enhance products, services, and efficiency Maintains responsibility for preserving the member's confidentiality. This includes recognizing that member information is disseminated only per signed release, as mandated by state and/or federal law, and on a need to know basis. A yearly confidentiality statement will be reviewed and signed Performs other duties and participates in special projects as assigned Qualifications Strong verbal communication and telephone skills Excellent follow-up skills Excellent organizational skills Strong keyboarding skills; typing, word processing, data entry Ability to maintain friendly and professional demeanor in a fast-paced work environment Knowledge of mental health and medical healthcare industry or similar background helpful Excellent working knowledge of various relational databases including Microsoft Access, Crystal Reports Microsoft Word, Excel, and Outlook
Visit our website at:www.apshealthcare.comReferral bonus available to APS Healthcare Employees*
In accordance to guidelinesAPS HEALTHCARE Bethesda, Inc. and its subsidiaries and affiliates (APS) are equal opportunity employers which employ qualified individuals based upon job related qualifications regardless of race, religion, color, sex, national origin, age, disability, or any other classification proscribed under applicable federal, state, or local law. APS complies with the law regarding reasonable accommodation for disabled employees. Applicants requiring reasonable accommodation in order to participate in the interview process are requested to contact Human Resources in order to arrange such accommodation.
REQUIREMENTS
Requirements:
Two years experience in an office environment with emphasis on administrative and /or clerical support and customer service Previous claims experience in health care/ insurance is mandatory Experience in research, able to extract information from printed and automated resources on a regular basis
Education:
High School diploma or equivalent