Job Description

Job Title: Business Analyst III
Job Location: Pennsylvania

Responsibilities:

  • Perform various analysis and interpretation to link business needs and objectives for assigned function
  • Support business initiatives through data analysis, identification of implementation barriers, and user acceptance testing of various systems
  • Identify and analyze user requirements, procedures, and problems to improve existing processes
  • Perform detailed analysis on multiple projects, recommend potential business solutions, and ensure successful implementations
  • Identify ways to enhance performance management and operational reports related to new business implementation processes
  • Coordinate with various business units and departments in the development and delivery of training programs
  • Develop, share, and incorporate organizational best practices into business applications
  • Diagnose problems and identify opportunities for process redesign and improvement
  • Formulate and update departmental policies and procedures
  • Serve as the subject matter expert on the assigned function product to ensure operational performance

Required Qualifications:

  • Bachelor’s degree in related field or equivalent experience
  • Four to six years of business process or data analysis experience, preferably in healthcare
  • Four+ years of business process analysis, preferably in healthcare (i.e. documenting business process, gathering requirements) or claims payment/analysis experience
  • Experience in benefits, pricing, contracting, or claims and knowledge of provider reimbursement methodologies
  • Experience in healthcare industry, preferably with managed care techniques and administrative philosophy
  • Three+ years of managed care encounters experience
  • Experience with encounters or claims business analysis experience in healthcare, preferably managed care or Medicaid
  • Experience in healthcare industry, preferably with managed care techniques and administrative philosophy
  • Experience working with and leading diverse teams in matrix managed environments
  • Experience managing projects with a high reliance on technology

Preferred Qualifications:

  • Advanced knowledge of Microsoft Applications, including Excel, Access, and Visio
  • Project management experience
  • Knowledge of managed care information or claims payment systems
  • Previous structured testing experience
  • Experience in claims coding analysis or medical claim review/research
  • Knowledge of Amisys claims payment system and Business Objects
  • Knowledge of Amisys or other claims system, HIPAA transactions (i.e. 837, 999, 824, 277) and SQL Scripting
  • Knowledge of data migration, software enhancement/planning, and Agile

QBH#: 2033

Application Instructions

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