Please note: Only considering candidates with extensive experience with the below***
Absolute Must have
Strong Healthcare Domain background
Strong Experience With Claims Adjudication And Claims Processing
Strong experience with EDI processes, 837, 834, 270, 271, 835 etc
Experience in a software application development environment in an analytical role
Position Purpose:
Senior Business Analyst will be responsible for researching, writing requirements (including data mapping), and sharing information with Plans on clients EDI changes.
May at times need to write business intent, business requirements, functional requirements, non-functional requirements, and system/process impacts for Claims and Audit processes and systems.
Position Requirements:
10 Years Experience
Strong demonstrated analytical skills applied to business software solutions maintenance and/or development.
Knowledge of health care claims adjudication processes, logic and data
Hands-on X12 health care insurance transaction (834, 837, 270, 271, etc.) data mapping and issue resolution experience
Knowledge of the software development standards and practices.
Demonstrated ability to find efficiencies and improve processes.
Proven ability to determine systemic process faults and improve overall process performance across organizations.
Understanding of claims adjudication, particularly in a health care environment
Understanding of health industry diagnosis, procedure and revenue codes and their application
Strong business analytical skills.
Strong process analysis skills
Strong process documentation skills
Excellent communication/writing skills,
Excellent interpersonal skills
Attentive to detail, highly -organized, and able to multi-task
Ability to work independently and meet deadlines
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Other
Industries
IT Services and IT Consulting
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