Claims Analyst

In alignment with UCSF Health’s Strategic Plan, UCSF made a strategic decision to advance UCSF’s commitment to the Epic Community Affiliate program. This program allows UCSF to extend our substantial investment in Epic to other hospitals and clinics in Northern California. UCSF has fostered significant clinical care relationships with other health care organizations, creating a network that builds continuity of care across UCSF and the broader community. The Community Affiliate program provides a shared clinical record that will improve care coordination and smooth transitions between patient care locations. Additionally, it allows for better continuity and more appropriate treatment for the patient while lowering costs through elimination of duplicative services across multiple settings.  This role is accountable to Community Affiliates and will be an integral team member in delivering the services and support. This position will be working at various locations both at UCSF and Community Affiliate locations.

The APeX Application Analyst will primarily be responsible for developing, supporting and maintaining Epic's  Claims and related 3rd Party Applications. They work under the direction of the Team Lead and/or Manager to configure, build & install the application. They coordinate all issues that arise during the project for their application area. Key operational activities include primary responsibility to analyze work flows and understand policies, procedures and constraints of the clinical or business operations support by the application. In depth and precise investigation and documentation of operational specifications and application functionality is required.  Key technical activities include the analysis of new releases to determine how workflow should be modified, building and populating databases and tables during initial system configuration, conducting system testing and conversion data validation. The application analyst develops and documents internal procedures and establishes change control processes for the application. 

• Develops/design advance/complex programs and guides their develop with members of a cross functional team
• Works independently and in consultation with team lead and/or manager
• Application expertise to define “integrated” system design requirements and develop/implement complex application components
• Able to negotiate scope/approach with team, end users and IT infrastructure partners
• Principal contact for resolution of complex integrated issues and/or solutions
• Familiar with Epic Claims build
• Proficient in 3rd Party systems that enable claims submission and remit processing in Epic.
• Must have certification and experience with Epic . Claims certification must be achieved within 6 months of hire.

Department Overview 

The Clinical Systems Applications Team is responsible for designing, testing, and implementing the clinical and business application aspects of UCSF’s Electronic Health Record.  This includes interoperability with other third party systems and devices.

Our Core Values include: 

• Judgment: Makes wise decisions, root causes, thinks strategically, and prioritizes what to do now and what can be improved later.
• Communication: Listens well, concise and articulate in speech and writing, treat people with respect independent of their status or disagreement with you & maintain calm poise in stressful situations.
• Impact: Accomplish amazing amounts of important work, colleagues can rely upon you, focus on results, exhibit bias-to-action, and avoid analysis-paralysis
• Innovation: Find practical solutions to hard problems, suggest better approaches, new ideas that prove useful, stay nimble by minimizing complexity and finding time to simplify.