Position Purpose:
- Perform various analysis and interpretation to link business needs and objectives for assigned function
- Support business initiatives through data analysis, identification of implementation barriers and user acceptance testing of various systems
- Identify and analyze user requirements, procedures, and problems to improve existing processes
- Perform detailed analysis on multiple projects, recommend potential business solutions and ensure successful implementations
- Identify ways to enhance performance management and operational reports related to new business implementation processes
- Coordinate with various business units and departments in the development and delivery of training programs
- Develop, share, and incorporate organizational best practices into business applications
- Diagnose problems and identify opportunities for process redesign and improvement
- Formulate and update departmental policies and procedures
- Serve as the subject matter expert on the assigned function product to ensure operational performance
Education/Experience:
- Bachelor’s degree in related field or equivalent experience
- 4-6 years of business process or data analysis experience, preferably in healthcare
- Advanced knowledge of Microsoft Applications, including Excel and Access preferred
- Project management experience preferred
Recommended Requirements:
- Bachelor’s degree in related field or equivalent experience
- 4+ years of business process analysis, preferably in healthcare (i.e. documenting business process, gathering requirements) or claims payment/analysis experience
- Advanced knowledge of Microsoft Applications (Excel, Visio, Access preferred)
- Experience in benefits, pricing, contracting or claims and knowledge of provider reimbursement methodologies
- Knowledge of managed care information or claims payment systems preferred
- Previous structured testing experience preferred
- Experience in healthcare industry, preferably with managed care techniques and administrative philosophy
- Experience in claims coding analysis or medical claim review/research preferred
- Knowledge of AMISYS claims payment system, business objects, HIPAA transactions (i.e. 837, 999, 824, 277) and SQL Scripting preferred
- Experience with encounters or claims business analysis experience in healthcare, preferably managed care or Medicaid
- Knowledge of data migration, software enhancement/planning, and Agile preferred
- Experience managing projects with a high reliance on technology