Seeking a methodical, highly-analytical Senior Business Process Analyst with healthcare industry experience to support strategic operational process improvement initiatives. The Senior Business Process Analyst will support business initiatives with various operational departments including Benefits, Provider Data, Utilization Management, Claims, Compliance, and Audit. The Senior Business Process Analyst must possess a thorough understanding of healthcare payer systems, managed care, fee schedules, physician pricing, authorization requirements, and data collection and analysis. Core responsibilities include:
- Analyzing business requirements to determine optimal configuration.
- Performing trouble-shooting and root cause analysis of known problems or functionality issues. Recommend solution to resolve and/or to improve functionality.
- Performing master-file analysis and maintenance.
- Setting-up and maintaining diagnosis, CPT, and other medical codes.
- Creating and maintaining provider reimbursement.
- Configuring, testing, and documenting recommended solutions.
- At least 6+ years’ experience as a Business Analyst in a healthcare organization.
- Knowledge of and ability to maintain standard configurations, templates, and customization.
- Advance proficiency with MS Office Suite.
- Excellent verbal and written communication skill.
- Ability to handle a fast-paced work environment, adapt to changing priorities and work load volumes, and meet strict deadlines.
- Prior knowledge of the following extremely beneficial: ICD9-CM, ICD10, CPT-4, HCPCS codes; Medicaid, Medicare Advantage, Health Care Exchange; UB-04 and HCFA claims processing; and EHS or DST configuration experience.
International Financial Group helps with effective resume development, career coaching, and interview preparation to give you an edge in securing your next employment opportunity. If you are qualified and interested in this opportunity, please apply.
We are an experienced, enthusiastic, and dedicated group of professionals working together to deliver a customized strategy that exceeds the needs and expectations of our candidates and clients. Our strict focus on Finance, Accounting, Tax & Audit allows us to remain agile and deeply engaged. We place tremendous value on understanding the unique strengths and desires of the candidates we represent and the specific needs and requirements of our clients. We understand that clients require qualified, experienced professionals for permanent/full-time opportunities, as well as to assist them with the successful execution of “just-in-time”, short term special projects and interim / transitional initiatives. We serve as trusted advisors, building lasting relationships with both the candidates we represent and our clients to ensure overall success; and have been recognized for our flexibility and ability to truly create a solution where everyone benefits, while never compromising quality.
We welcome the opportunity to meet with you and discuss in greater detail how we can be of assistance.