Quality Assurance Business Analyst
6 days ago
Job Title: Quality Assurance Business Analyst
Job Summary:
We are seeking a Quality Assurance Business Analyst to join our team. The successful candidate will be responsible for handling claims production tasks, assessing FEP procedures and regulations, and identifying process improvements.
Key Responsibilities:
- Handle claims production tasks such as written inquiries and reconsiderations and related adjustments to attain FEP Performance metrics.
- Assess FEP procedures and regulations and required controls and incorporate what is required into the specifications and/or documentation.
- Identify process improvements and develop workflow and/or system recommendations.
- Support FEP audits, including research claims related issues/questions and preparation of appropriate audit responses as well as represent IBX in the audit presentation to FEP Directors Office, BCBSA, if needed.
- Support assigned projects related to FEP, maintain appropriate documentations at a task level, monitor deadlines and service as subject matter expert when appropriate.
- Develop and maintain user documentation/desk level procedures ensuring the most current information is available to the claims team.
- Work with the Business Support team in reviewing FEP release documentation and participate in testing initiatives as needed.
- Communicate effectively in writing and verbally in work groups and with internal and external customers.
- Attend internal and external education training to achieve and maintain proficiency on all systems.
Requirements:
- High School Diploma or GED, 4 years' experience in a Claims/Service operations environment OR Associate degree or minimum two-year Federal Employee Health Benefits Plan work-related experience, bachelor's degree preferred.
- Knowledge of systems, process flows, regulatory impacts, and timelines to ensure requirements, testing and implementation are in compliance across operational disciplines.
- Excellent written and verbal communication skills are required to provide business units with information.
- Maintain flexibility in a team environment and identify process improvement opportunities and define system impacts that may result.
- Experience in auditing, quality review or transaction processing experience.
- Demonstrated understanding of FEP policies, processing standards and guidelines.
About Us:
Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, colour, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
-
Business Systems Analyst
3 weeks ago
Philadelphia, Pennsylvania, United States Serigor Inc. Full timeJob Title: Business Systems Analyst (SQL)Overview:At Serigor Inc., we are seeking a skilled SQL Business Systems Analyst to join our EIM Data Warehouse team. The ideal candidate will have extensive experience in creating Business Requirement Documents, Functional Requirement Documents, and Mapping documents for the development of ETL applications.Key...
-
Business Analyst
4 weeks ago
Philadelphia, Pennsylvania, United States Esperanza Health Center Full timeWe are seeking a Business Analyst to join our team at {company}. As a Business Analyst, you will be responsible for analyzing business needs and developing solutions to meet those needs. This is an exciting opportunity to work with a dynamic team and contribute to the growth and success of our organization.Key Responsibilities:Collect and analyze business...
-
Business Systems Analyst
2 days ago
Philadelphia, Pennsylvania, United States Axelon Full timeJob Title: Business Systems AnalystWe are seeking an experienced Business Systems Analyst to work on complex projects, focusing on data warehousing, SQL, and business analysis. The ideal candidate will collaborate with stakeholders, define requirements, manage deliverables, and ensure alignment between business needs and technical solutions.Key...
-
Senior Business Analyst
6 days ago
Philadelphia, Pennsylvania, United States Community Behavioral Health Full timeSr. Business AnalystJob Summary:The Senior Business Analyst will act as a liaison between CBH stakeholders and information technology to understand the structure, policies, and operations of the organization. This individual will recommend effective solutions to enable the organization to achieve its goals through the use of technology.Key...
-
Quality Assurance Director
4 days ago
Philadelphia, Pennsylvania, United States Mallard Executive Search Full timeAs a Quality Assurance Superintendent with Mallard Executive Search, you will lead the quality control efforts at a food manufacturing facility located about an hour outside of Philadelphia, PA. This role requires a strong background in USDA regulations and experience working in a similar position. A 4-year degree is also essential for this position.Key...
-
Director of Quality Assurance and Compliance
6 days ago
Philadelphia, Pennsylvania, United States Proclinical Staffing Full timeOverview:Proclinical Staffing is a specialist employment agency and recruitment business, providing job opportunities within major pharmaceutical, biopharmaceutical, biotechnology and medical device companies.About the Role:We are seeking an experienced DIRECTOR OF QUALITY ASSURANCE AND COMPLIANCE to join our growing team in Philadelphia, PA. The successful...
-
Quality Assurance Engineer
5 days ago
Philadelphia, Pennsylvania, United States Capgemini Full timeCapgemini is a global leader in consulting and digital transformation. We are currently seeking an experienced Quality Assurance Engineer to join our team.The ideal candidate will have a strong background in testing Telcom Resi products, including HSD and Voice, as well as UI and API Testing. Experience with Biller (CRM/ACSR), Jira, AppD, and Kibana is also...
-
Philadelphia Business Innovation Analyst
5 days ago
Philadelphia, Pennsylvania, United States City of Philadelphia Full timeBusiness Innovation Analyst Role OverviewWe are seeking an innovative and strategic Business Analyst to join our team at the City of Philadelphia. This role will be responsible for guiding technology-related business process initiatives that align with the city's strategic priorities.About UsThe City of Philadelphia is a vibrant and diverse city that offers...
-
Chief Quality Assurance Officer
6 days ago
Philadelphia, Pennsylvania, United States Gift of Life Donor Program Full timeAbout the RoleWe are seeking a highly skilled Director, Quality to join our team at the Gift of Life Donor Program. This is an exciting opportunity for a seasoned professional to lead our quality assurance and clinical regulatory functions.Job SummaryThe successful candidate will be responsible for ensuring that our organization meets the requirements of all...
-
Senior Quality Assurance Specialist
4 days ago
Philadelphia, Pennsylvania, United States Capgemini Full timeCapgemini is a global leader in consulting and digital transformation. We are looking for an experienced Senior Quality Assurance Specialist to join our team in Philadelphia, PA.We offer a competitive salary of approximately $95,000 - $110,000 per year, depending on experience.About the Role:The Senior Quality Assurance Specialist will be responsible for...
-
Senior Business Systems Analyst
7 days ago
Philadelphia, Pennsylvania, United States Lorven Technologies Full timeAbout the Role:Lorven Technologies seeks a highly skilled Senior Business Systems Analyst to join our team and contribute to the development of our data warehousing solutions. As a Senior Business Systems Analyst, you will be responsible for gathering and analyzing business requirements, creating business requirement documents, and mapping documents for the...
-
Business Systems Analyst
4 days ago
Philadelphia, Pennsylvania, United States Serigor Inc Full timeJob Title: Business Systems AnalystJob Summary: As a key member of our team at Serigor Inc, the successful candidate will be responsible for creating Business Requirement Documents, Functional Requirement Documents, and Mapping documents for ETL applications. The ideal candidate will have extensive SQL experience, data analysis, and strong verbal and written...
-
Enterprise Healthcare Business Analyst
7 days ago
Philadelphia, Pennsylvania, United States Brooksource Full timeJob Title: Enterprise Healthcare Business AnalystBrooksource is seeking an experienced Enterprise Healthcare Business Analyst to join our team in Philadelphia, PA. This 6-month contract has strong potential for extension.The successful candidate will be the liaison between different teams such as developers, testers, project managers, and business...
-
Packaging Quality Assurance Expert
2 days ago
Philadelphia, Pennsylvania, United States Crown Cork & Seal USA, Inc. Full timeJob DescriptionCrown Cork & Seal USA, Inc. is a leading provider of innovative packaging solutions for consumer goods.About the Role: We are seeking a seasoned Packaging Quality Assurance Expert to join our team in the Mid-Atlantic or Northern Midwest region.Key Responsibilities:Provide expert-level quality assurance and continuous improvement guidance to...
-
Executive Director, Quality Assurance
2 days ago
Philadelphia, Pennsylvania, United States Crown Cork & Seal USA, Inc. Full timeCrown Cork & Seal USA, Inc., a global leader in packaging products for consumer goods, seeks an Executive Director, Quality Assurance to join its team. The ideal candidate will possess a strong background in quality management and food safety.The company offers a competitive salary of $120,000 - $180,000 per year, depending on experience, as well as...
-
Production Support Business Systems Analyst
1 week ago
Philadelphia, Pennsylvania, United States Partner's Consulting Inc Full timeJob Title: Production Support Business Systems AnalystLocation: RemoteType: Contract-to-HireOur client, a leading consulting firm, is seeking a Production Support Business Systems Analyst to support customer-facing applications. The ideal candidate will have a basic understanding of key concepts and features of the subject matter and experience supporting...
-
Senior Quality Assurance Specialist
7 days ago
Philadelphia, Pennsylvania, United States PCI Pharma Services Full timeAbout PCI Pharma ServicesWe are a leading global contract development and manufacturing organization (CDMO) providing comprehensive solutions for the pharmaceutical and biotechnology industries. Our purpose is to enable life-changing therapies through accelerated development, reliable manufacturing, and flexible packaging.Job SummaryThe Senior Quality...
-
Quality Assurance Specialist
6 days ago
Philadelphia, Pennsylvania, United States Chili's Grill & Bar Full timeRole Overview:Chili's Quality Assurance Specialists deliver exceptional Guest experiences by ensuring high-quality food and dependable, fast service. This role requires a team player who thrives in a fast-paced environment and can multitask effectively.Responsibilities:• Prepare food to company standards and specifications• Maintain a smooth flow of food...
-
Business Intelligence Analyst
7 days ago
Philadelphia, Pennsylvania, United States Comcast Corporation Full timeJob DescriptionThe Senior Business Intelligence Analyst will play a crucial role in enhancing financial and operational reporting capabilities at Comcast Corporation. This position involves developing and maintaining reports within the OneStream platform, ensuring accurate data integration from multiple sources.Key Responsibilities:Design, build, and...
-
Plastic Quality Assurance Specialist
4 days ago
Philadelphia, Pennsylvania, United States The Judge Group Full timeAbout the Role:As a Plastic Quality Assurance Specialist with The Judge Group, you will play a critical role in ensuring the quality of plastic products. This position requires a meticulous eye for detail and a strong analytical mind.Responsibilities:Inspect raw materials, in-process components, and finished plastic products to ensure they meet...