Marijes Gomez
Burbank,CA
Summary
Data Integrity Program Analyst with experience in behavioral health operations, EHRS systems, and DMH compliance. Proven ability to manage onboarding / offboarding, maintain data accuracy across multiple systems, and support billing and regulatory requirements. Skilled in identifying data discrepancies, improving workflows, and ensuring 100% compliance with licensing and training standards.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Data Integrity Program Analyst
Children's Institute, Inc. (CII)
Los Angeles
07.2021 - Current
- Lead onboarding / offboarding processes for new hires and trainees, ensuring providers are fully credentialed and system-ready for timely billing
- Ensure accurate provider setup, including NPI, taxonomy codes, and EHRS setup to prevent claim denials and billing delays
- Validating practitioner data in NAPPA and NPPES, including FTE hours, locations, and associations to ensure billing accuracy and compliance
- Maintain compliance with licensing, training certificates, and documentation requirements to support audit readiness and billing eligibility
- Generate and analyze billing-related reports, including eligibility (Covivitas), SIFT, EDI files, and Exym dashboard to support revenue cycle processes
- Conduct EHR (Exym) audits and data validation to identify and resolve discrepancies impacting claims
- Act as primary DMH liaison for System Access Request (SAR), coordinating staff access to DMH portals.
- Assist Billing and Revenue Team with outcome measures, discharges, special projects, and resolution of Exym-related billing issues; provide coverage during staff absences to ensure continuity of operations
Associate Director, Revenue Management
Children's Bureau (All 4 Kids)
Los Angeles, CA
01.2019 - 06.2021
- Supported revenue cycle operations by preparing Cost Reports, Negotiation Package, and other county / state reports. This includes validating and reconciling internal data and DMH data
- Produced and distributed financial, productivity, and billing performance reports to support program operations and leadership decision-making
- Monitored DMH and EDI updates, ensuring timely communication of system changes impacting billing processes
- Analyzed billing and financial data to identify discrepancies and improve revenue cycle performance.
HIM Supervisor / EHRS Billing Coordinator
Children's Institute Inc. Cii
Los Angeles, CA
10.2016 - 12.2018
- Oversaw front-end billing operations, ensuring timeliness, accuracy, eligibility verification, and proper data entry within EHRS
- Collaborated with Behavior Health & Wellness Department leadership to manage client service records, front-end claiming processes, technical reviews outcomes, and chart access
- Monitored EDI workflows and claim submission to ensure accurate billing to DMH
- Partnered with leadership and EHRS analyst to maintain DMH Integrated Systems and EHRS databases, ensuring data integrity and compliance.
- Collaborated with leadership and Quality Assurance & Improvement Team to improve appropriate documentation and billing compliance
Education
Medical Assistant -
North West College
Glendale, CASkills
- EHRS: Exym
- DMH Systems: NAPPA, System Access Request (SAR), DMH Heat, FSP and PEI Outcome Measures, Consumer Perception Surveys (CPS), SRTS, WTS
- Data & Reporting: EDI (SIFT), Covivitas, Exym Dashboard
- Compliance: Licensing, Credentialing, Training Compliance, Medi-cal Billing
- Operations: Onboarding / Offboarding, Cross-Functional Collaboration
Certification
Netsmart Evolv System Administration Certification
Timeline
Data Integrity Program Analyst
Children's Institute, Inc. (CII)
07.2021 - Current
Associate Director, Revenue Management
Children's Bureau (All 4 Kids)
01.2019 - 06.2021
HIM Supervisor / EHRS Billing Coordinator
Children's Institute Inc. Cii
10.2016 - 12.2018
Medical Assistant -
North West College