Senior Analyst

Senior Business Analyst

The Senior Business Analyst will be responsible for researching, writing requirements (including data mapping), and sharing information with Plans on client EDI changes. May at times need to write business intent, business requirements, functional requirements, non-functional requirements, and system/process impacts for client Claims and Audit processes and systems.

Position requirements include:

• 5-8 years experience
• Excellent 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
• Excellent business analytical skills.
• Excellent process analysis skills
• Excellent 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

Preferred:

• Experience with claims adjudication in the client system.