Business Analyst focusing on SCCL regulation, partnering with IT and Data teams for compliance and data integrity. Collaborating on business logic for exposures and mitigants while conducting thorough data validations and testing.
About the role
- Business Analyst III identifying and analyzing overpayment recovery opportunities. Collaborating on business cases for cost of care savings in a hybrid work environment.
Responsibilities
- Responsible for identifying, analyzing, and validating overpayment recovery opportunities.
- Translate moderately complex and varied business needs into business cases or business requirements document (BRD).
- Create data mining queries that will contribute to cost of care savings.
- Migration of datamining concepts and ensuring new systems meet department needs.
- Auditing claims payment to identify overpayment scenarios.
- Determines specific business application software requirements to address complex business needs.
- Develops project plans and identifies and coordinates resources, involving those outside the unit.
- Works with programming staff to ensure requirements will be incorporated into system design and testing.
- Acts as a resource to users of the software to address questions/issues.
- May provide direction and guidance to team members and serves as an expert for the team.
Requirements
- Requires a BA/BS and minimum of 5 years business analysis experience; or any combination of education and experience which would provide an equivalent background.
- Knowledge of systems capabilities and business operations is strongly preferred.
- Ability to manage multiple projects in various stages to completion preferred.
- In-depth knowledge of WGS claims processing, reimbursement policies and procedures preferred.
- Strong analytical and problem-solving skills with research-oriented approach preferred.
- Proficiency in Microsoft Excel preferred.
Benefits
- Hybrid work arrangement
- Merit increases
- Paid holidays
- Paid Time Off
- Incentive bonus programs
- Medical benefits
- Dental benefits
- Vision benefits
- Short and long term disability benefits
- 401(k) + match
- Stock purchase plan
- Life insurance
- Wellness programs
- Financial education resources
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
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