Healthcare Business Analyst - Expert Claims Review
Zelis
This job is no longer accepting applications
See open jobs at Zelis.See open jobs similar to "Healthcare Business Analyst - Expert Claims Review" Edison Partners.Position Overview
The Business Analyst is responsible for enabling high quality business analytics solutions in an Agile framework that delivers valued business outcomes and informed decisions for Zelis’ key stakeholders for the Expert Claims Review solution umbrella. The Business Analyst works as part of the Product team to facilitate clear and open communication between Business Owners, Scrum/Development, Quality Assurance, UAT and Product Owners. This role provides a major contribution to enhancing Zelis’ overall capacity to meet the information technology needs of an ever-changing payment integrity market.
Key Responsibilities
Act as a Subject Matter Expert liaison between teams
Gather requirements/acceptance criteria for Expert Claims Review initiatives centered around handling of medical pre-payment and post-payment claims for accurate claim payment review through our suite of solutions
Provide documentation for system/process updates and existing system functionality for reference by operations and alternate teams
Work closely with Product Management, Development, QA and UAT to ensure requirements are realized properly upon release to production
Assist in providing training to operations on newly released items
Recommend process, workflow and efficiency improvements while keeping the team informed on upcoming product development improvements and new product solutions being taken to market
Draft and send release notes and organize user requirements by scheduling meetings with appropriate stakeholders to track and manage accordingly
Qualifications
Basic or advanced understanding of payment integrity, claim processing and/or revenue cycle for healthcare claims
Understanding of medical coding and medical claims
Ability to see the big picture and learn new processes, technologies and envision how they could benefit Zelis
Ability to partner with one or more Product Owners on key initiatives and prioritization efforts
Project Management experience; ability to drive output from others without direct supervisory responsibility
Excellent problem solving and analytical skills
Ability to prioritize and manage multiple concurrent projects
Moderate to advanced experience with Microsoft Office Suite, JIRA + Confluence
#LI-RZ1
As a leading payments company in healthcare, we guide, price, explain, and pay for care on behalf of insurers and their members. We’re Zelis in our pursuit to align the interests of payers, providers, and consumers to deliver a better financial experience and more affordable, transparent care for all. We partner with more than 700 payers, including the top-5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, over 4 million providers, and 100 million members, enabling the healthcare industry to pay for care, with care. Zelis brings adaptive technology, a deeply ingrained service culture, and a comprehensive navigation through adjudication and payment platform to manage the complete payment process.
Commitment to Diversity, Equity, Inclusion, and Belonging
At Zelis, we champion diversity, equity, inclusion, and belonging in all aspects of our operations. We embrace the power of diversity and create an environment where people can bring their authentic and best selves to work. We know that a sense of belonging is key not only to your success at Zelis, but also to your ability to bring your best each day.
Equal Employment Opportunity
Zelis is proud to be an equal opportunity employer. All applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
We encourage members of traditionally underrepresented communities to apply, even if you do not believe you 100% fit the qualifications of the position, including women, LGBTQIA people, people of color, and people with disabilities.
Accessibility Support
We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email TalentAcquisition@zelis.com
SCAM ALERT: There is an active nationwide employment scam which is now using Zelis to garner personal information or financial scams. This site is secure, and any applications made here are with our legitimate partner. If you’re contacted by a Zelis Recruiter, please ensure whomever is contacting you truly represents Zelis Healthcare. We will never asked for the exchange of any money or credit card details during the recruitment process. Please be aware of any suspicious email activity from people who could be pretending to be recruiters or senior professionals at Zelis.
This job is no longer accepting applications
See open jobs at Zelis.See open jobs similar to "Healthcare Business Analyst - Expert Claims Review" Edison Partners.