Business Analyst AHA (Finance)

Business Analyst is needed to support daily operations for provider/claim team.  This critical work will assist move forward resolution of operational challenges, improve current processes, support project management initiatives.

 

·        Support the provider/claim operations team with analysis of provider data structure issues, related claim payment, benefit network maintenance and provider demographic structure. Perform root cause analysis and course correct identified issues for full resolution.

·        Research root cause of failed payments to determine if it is Provider related. If so, provide solution and coordinate with appropriate team members to repair provider record, pull claims for reprocessing through the bots and ensure payments are reissued correctly (working with Provider File Support, Claims and Issue Management teams). Provide updates to Provider Relations as necessary for escalated claims.

·        Focus on applying technologies to continuously increase claims process improvements with the use of data, Bots and applications/tools. 

·        Share this knowledge and skill with other team members to instill across the team the opportunities that they can escalate to process improve.  Schedule reoccurring meetings to keep momentum.

·        Responsible for evaluating current business processes and developing, implementing, testing and maintaining Technology for more cost effective or quality improvement processing.

·        Assist pulling needed data and in the documentation of processes and work procedures.

·        Perform other duties as assigned.

• Advanced skills in Microsoft Office and with Microsoft platforms (e.g. Excel, Word, PowerPoint) is required; working experience with SQL and Access preferred. Experience with technologies, desktop tools and or Operations processes and technology is helpful

Qualifications

 

Education

• Bachelor's Degree in Business, Computer Science, Mathematics, Information Systems or equivalent work experience preferred

Experience

Knowledge, Skills, Abilities            

• Highly self-motivated, highly organized and detailed oriented as well as above average problem solving, analytical, and verbal and written communication skills are required.
• Must have a general understanding of the business environment and associated systems with experience interfacing with Management and awareness of current trends in Technology.

 

Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.