Catholic Community Services · 1 day ago
Data Management Specialist 1
Tacoma, WA
Full-time
Onsite
Entry Level
$27.74/hr - $30.86/hr
3+ years expCatholic Community Services is a values-driven organization providing family-oriented behavioral health care. They are seeking a Data Management Specialist to oversee the authorization process and manage complex data and medical insurance claims, ensuring compliance and accuracy in documentation and reporting.
Social MediaCommunities
Responsibilities
Oversee authorization process; ensure clinical staff complete all information supporting Medical Necessity for service authorization. Negotiate changes and exceptions with utilization review department of each MCO to ensure compliance
Create new consumer records in CareLogic (FBH’s electronic health record) using eligibility information from MMIS, CIM3 (HSO), and CIM6 (Family Care), Optum Provider Express (UBH), and One Health Port (other private insurance)
Enter high volume of enrollment and discharge data into MOTS (Measures and Outcomes Tracking System) for all clients with OHP (Oregon Health Plan) coverage
Complete high volume of timely and accurate data entry from psychiatrist, QMHP, Peer Partner, and QMHA direct service staff documentation into
Create and maintain employee records in CareLogic with WISe (Medicaid) number and credentialing updates as needed
Communicate employee WISe, NPI and credentialing changes to PhTech
Complete high volume of timely and accurate data entry into CareLogic regarding changes in consumer services and consumer exits. Monitor and adjust coding as funder changes occur, including NCCI edits, credentialing, and per diem contract updates
Assist CQI leadership in preserving data integrity for audit purposes
Verify data input and coordinate with Oregon and Washington office staff to make appropriate corrections (batch error handler)
Oversee and advise new staff members making timely and accurate submission of invoicing for FSE and other contracts
Oversee and provide monthly certification of data within contract parameters and verification through MMIS, CIM3 (HSO), and CIM6 (Family Care), Optum Provider Express (UBH), and One Health Port (other private insurance)
Recommend and participate in implementation of reporting and database management changes
Develop and distribute reports to leadership, both routine and ad hoc from CareLogic, including staff productivity, consumer outcome and service reports
Develop and distribute reports to funders according to contract requirements regarding consumer outcome, service reports, and staff credentialing
Track consumers by service type at intake and exit using current data collection system
Support Quality Management with the collection and processing of information for internal and external stakeholders, such as satisfaction surveys, outcome information, etc
Back up support for all tasks assigned to Claims Management Specialist
Other duties as assigned
Qualification
Required
High School Diploma or equivalent
Age 21 or older
One or more years of data entry experience
Three or more years' experience working in an office setting
Demonstrate effective verbal and written communication
Ability to work both independently and as a member of a team
Demonstrates the necessary attitudes, knowledge and skills to deliver culturally competent services and work effectively in multi-cultural situations
Strong computer skills especially in Outlook, Word, Excel, and database management systems and knowledge and/or demonstrated ability utilizing electronic healthcare record systems is desired
Excellent organizational skills and ability to work in a busy and diverse environment
Applicant must successfully pass required background clearances prior to an offer of employment
Support and uphold the mission, beliefs and values of Catholic Community Services and Catholic Housing Services
Preferred
Experience with electronic medical records
Knowledge of medical insurance claims management procedures and verbiage
Ability to analyze consumer data and make recommendations
Knowledge of accounting principles
Knowledge of HIPAA guidelines
Benefits
12 paid holidays; plus 1 personal holiday each year!
3 weeks' vacation per year
12 sick-days per year
Medical
Dental
Vision Insurance
Life Insurance (1 times annual salary)
Retirement Plans: 403-B Employee Savings Plan and an Employer Contribution Pension
Company
Catholic Community Services
WE BELIEVE … in compassion, love and respect for all people, especially those who are poor and vulnerable.
1001-5000 employees
Funding
Current Stage
Late StageTotal Funding
$10MKey Investors
Cambia Health FoundationDay One Fund
2025-05-13Grant
2023-11-21Grant· $5M
2018-11-20Grant· $5M
Leadership Team
Timothy May
Vice President & CFO
Recent News
2024-02-01
2023-12-26
2023-12-26
Company data provided by crunchbase