BJC Careers

Workers Compensation Analyst

Saint Louis, MO
Support Services


Job Description

Job ID: 1178536
Employment Status: Full-Time
Regular/Temporary: Regular

Your Career. Made Better.

BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and mid-Missouri regions. BJC serves patients and their families in urban, suburban and rural communities through its 15 hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice.


Join Us!


Role Purpose

Maintains all departmental and regulatory databases, insuring the data accuracy and integrity. (Claims Management System, Business Objects and maintain all interfaces including Medical Bill Review (MBR), State of MO FROI, MMSEA (Medicare, Medicaid, SHIP (State Children’s Health Insurance Program) Extension Act of 2007) and Occupational Health database) Facilitate all Workers’ Compensation Administration (WCA) database upgrades and enhancements. Develops, regularly generates and distributes routine/ADHOC reporting for both external and internal WCA partners. All administration tasks associated with the department including answering the telephones, development of system generated letters, maintaining the electronic files, data analysis to help in determining areas of improvement, both in injury identification (areas and event) and moving to outcome based evaluations of providers/services.


Responsibilities

  • Organizes, implements, and monitors databases. Develops, implements and monitors functionality of the WCA databases. Performs all testing for pre-implementation of upgrades, along with assisting in the live implementation with the vendors and Department’s IS partners.
  • Interfacing with BJC, state, and federal departments. Daily Processing of Check with BJC AP department. Weekly filings and retrieval of Injury Reports to State. Quarterly filing and retrieval with the Federal department for MMSEA (Medicare, Medicaid, SHIP (State Children’s Health Insurance Program) Extension Act of 2007) section 111 reporting. Maintains all interfaces with MBR (Medical Bill Review), State of Missouri when transmission errors occur, will identify cause, correct and resubmit data.
  • Regulatory compliance Lead role in obtaining and sending data for compliance with the Federal MMSEA (Medicare, Medicaid, SHIP (State Children’s Health Insurance Program) Extension Act of 2007) per federal regulations to avoid potential penalty of $1,000.00 per day per incorrect data element. Responsible for the accuracy of the data and electronically submitting monthly/quarterly basis. ..
  • Data mining and analysis. Utilizes Business Objects to mine and analyze data. Create custom reports to trend data and statistics for internal, regulatory, and risk management.
  • Serve as educational and technical expert. Serves as the educational and technical expert resource for the WCA data systems

  • Minimum Requirements

     

    Degree

  • Bachelor's Degree
  • - Business/related

     

    Experience

  • 2-5 years

  •  

    Preferred Requirements and Additional Job Information

     

    Degree

  • Master's Degree
  • - Business/related

     

    Experience

  • 5-10 years

  • Benefits Statement

    Note: not all benefits apply to all openings

    -  Comprehensive medical, dental, life insurance, and disability plan options
    -  Pension Plan*/403(b) Plan
    -  401(k) plan
    -  Tuition Assistance
    -  Health Care and Dependent Care Reimbursement Accounts
    -  On-Site Fitness Center (depending on location)
    -  Paid Time Off Program for vacation, holiday and sick time

    *Pension does not apply to Memorial Hospital, Memorial Hospital East, Memorial Medical Group, Alton Memorial or Parkland Health Center


    Legal Statement

    The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job.

     

    Equal Opportunity Employer