Quality Business Analyst

Quality Business Analyst – FEP

Location:

3 months plus Contract-to-Hire

Pay rate: $31/HR W2

REMOTE/Hybrid Local to the office for hybrid in Philadelphia PA 19103 is highly preferred, but would consider remote candidates in Columbus, OH, Salt Lake, UT, Houston, TX and Bloomington, MN.

* Must be in tristate (PA, NJ, DE) or within an hour of Columbus, OH, Salt Lake, UT, Houston, TX and Bloomington, MN to be eligible to convert. Candidates must have hands on FEP Claims processing experience adjusting claims.

The FEP Claims Business Analyst supports FEP Claims Operations with Claims and inquiry inventory management by processing claims and inquiries. FEP Claims Business Analyst is responsible for the adjustment of claims, correct and timely completion of assigned work according to FEP policies and procedures.

• Review and perform transactions to ensure accuracy of transaction and system processing.
• Provide timely documented feedback on issues identified at the processor and/or system level and execute escalation procedures if applicable
• Ability to assess regulations and required controls and incorporating what is required into the specifications and/or documentation
• Identify process improvements and develop workflow and/or system recommendations
• Support assigned projects, maintain appropriate documentation at a task level, monitor deadlines and serve as a SME when appropriate
• Evaluate new modified processes and procedures to verify the new changes function as intended.
• Develop and maintain user documentation ensuring the most current information is available to the production areas.
• Compile and interpret data and handle reporting as required.
• Communicate effectively in writing and verbally with internal and external customers
• Attend internal and external education training to achieve and maintain proficiency on all systems
• Handle all other duties as assigned

• Knowledge of applications, process flows, regulatory or performance impacts to ensure compliance across operational disciplines. Including standard concepts, practices and procedures.
• Ability to compile detailed application data requirements for reporting and data mining to support business needs.
• Skilled in trend analysis and proficient in communicating as a liaison with business partners on findings and recommendations focused on minimizing impacts to other areas and the customer.
• Strong written and verbal communication skills.
• Maintain flexibility in a team environment and identify process improvement opportunities and define system impacts that may result.
• Minimum three (3) or more years of application and business process or transaction processing experience.
• Utilizes time management and limited experience and judgment to plan and accomplish goals.
• Ability to perform a variety of tasks both transactional and non-transactional.

• Requires a bachelor's degree or equivalent work-related experience

• 3-5 years of experience in FEP operations or in a related area.
• Experience with claim processing and adjustments
• Familiarity with the life of a claim and patient access to care concepts
• Familiarity with FEPDirect, Aerial, PNC Echo, SDS/Quick Claims, One Hub/Pulse, HRP, Source, Care First Bridge applications is a plus

Please apply with your interest. You may also reach out to me at  Thank you, Ashu

We provide a comprehensive package which includes. Benefits

• Medical for full time employees
• Dental, and Vision Insurance
• Life Insurance, Short-Term Disability, Long-Term Disability, etc.