BA with HC Claims Exp
BA with HC Claims Exp
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Salary Not Disclosed
1 Vacancy
Job Description
Were looking for a Business Analyst (BA) with significant experience in healthcare claims processing to join our team. The ideal candidate will be a critical link between our business operations and technical teams translating business needs into technical requirements to improve and optimize our claims systems. This role requires a deep understanding of the healthcare claims lifecycle including adjudication billing and payer-provider interactions.
Key Responsibilities
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Requirements Gathering & Analysis: Work closely with stakeholders to elicit document and analyze business requirements for claims processing projects. Translate these business needs into clear actionable functional and non-functional requirements.
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System & Process Improvement: Identify and recommend improvements to existing claims systems and workflows to enhance efficiency accuracy and compliance. This includes analyzing data to uncover trends and potential issues.
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Stakeholder Collaboration: Serve as a liaison between business users IT developers and quality assurance teams throughout the project lifecycle. Facilitate meetings and workshops to ensure alignment and clear communication.
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Documentation & Reporting: Create and maintain detailed documentation including business requirement documents (BRDs) use cases process flows and user stories. Develop reports and dashboards to track project progress and key performance indicators (KPIs).
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Testing & Validation: Support the testing phase by reviewing test plans and test cases to ensure they align with the original requirements. Assist in user acceptance testing (UAT) to validate that solutions meet business needs.
Qualifications
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Experience: A minimum of 8 years of experience as a Business Analyst with at least 4 years of direct experience in the healthcare claims domain.
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Knowledge: Strong understanding of the end-to-end claims lifecycle including concepts like adjudication EDI transactions (e.g. 837 835) coding (e.g. CPT ICD-10) and compliance standards (e.g. HIPAA).
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Skills:
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Excellent analytical and problem-solving abilities.
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Proficiency in business analysis tools (e.g. JIRA Confluence Visio).
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Exceptional communication and interpersonal skills.
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Ability to manage multiple projects and priorities in a fast-paced environment.
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Education: Bachelors degree in Business Health Informatics or a related field. Relevant certifications (e.g. CBAP) are a plus.
Required Skills : Business Analysis
Basic Qualification :
Additional Skills :
This is a high PRIORITY requisition. This is a PROACTIVE requisition
Background Check : Yes
Drug Screen : No
Employment Type
Full-time
