Experienced Claims Business Analyst

This is a fully remote position, open to applicants in Texas.

📋 Description

• Evaluate claims data to uncover denial patterns and operational challenges.

• Conduct thorough investigations of intricate claims issues to identify root causes.

• Offer actionable insights to facilitate issue resolution, enhancements, and system advancements.

• Work in collaboration with cross-functional teams to align claims outcomes.

• Create reports, dashboards, and monitoring tools to aid leadership in decision-making.

⛳️ Requirements

• Over 9 years of experience in claims business analysis, configuration, or healthcare operations.

• In-depth understanding of healthcare claims processing, encompassing coding (ICD-10, CPT, modifiers), billing, and adjudication regulations.

• Proficient in SQL and experienced in analyzing extensive datasets.

• Demonstrated capability to resolve complex problems and convert technical findings into business insights.

• Excellent communication and teamwork skills; experience in Medicaid or Medicare settings is preferred.

🏝️ Benefits

• Comprehensive health benefits.

• 401(k) employer matching.

• Flexible vacation policy.

• Educational assistance.

• Opportunities for leadership and technical development through academies.