Business Analyst

Job Overview
We are seeking a dynamic and detail-oriented Business Analyst to join our innovative team. In this role, you will be the vital link between business needs and technical solutions, driving data-driven decision-making and process improvements. Your energetic approach will help translate complex business requirements into actionable insights, supporting strategic initiatives across various departments. This is an exciting opportunity to leverage your analytical expertise and project management skills to make a meaningful impact within a collaborative environment.

This is a contract role (6-12 months) with the potential to become permanent. Sponsorship is not provided for this position.

All employees must work on-site 3 days per week in Philadelphia (Market Street).

The Business Analyst will support Claims Operations. You will move create resolutions of operational challenges, improve current processes and support project management initiatives. You will work closely with other team members and cross functional teams such as configuration and Account Management to resolve discrepancies and improve claims processing experience for members.

• Support the processing team with analysis of claim issues and inquiries. Perform root cause analysis and course correct identified issues for full resolution.
• Research root cause of incorrectly processed claims. Provide solution and coordinate with appropriate team members to repair the claim and provide re-education to the processor or submit ticket for system enhancement.
• Focus on applying technologies to continuously increase claims process improvements with the use of data, Bots and applications/tools. Share this knowledge and skill with other team members to instill across the team the opportunities that they can escalate to process improve.
• Schedule reoccurring meetings to keep momentum. Responsible for evaluating current business processes and developing, implementing, testing and maintaining Technology for more cost effective or quality improvement processing.
• Assist with pulling needed data and assist with the documentation of processes and work procedures. Represent Department as SME in meetings, projects and company initiatives

Required Experience:

• Advanced skills in Microsoft Office and with Microsoft platforms (e.g. Excel, Word, PowerPoint) is required
• Working experience with SQL (write queries)
• 3 years or more of experience in medical claims processing and adjusting or healthcare administration.

Preferred Experience:

Experience working with health systems in the billing revenue space working with health system provider data, and medical claims administration.

Technical Skills: Knowledge of medical billing codes (ICD-10, CPT, HCPCS), claims processing software. Ability to summarize large amounts of data and pivot data in multiple ways.

Analytical Skills: Ability to assess claim data in detail and identify errors or inefficiencies.

Communication Skills: Strong written and verbal communication skills for interacting with various stakeholders and resolving issues quickly.

Attention to Detail: High level of accuracy and thoroughness in reviewing claims for clients.

Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.

Pay: $52.00 per hour

Work Location: Hybrid remote in Philadelphia, PA 19102