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Healthcare Business Analyst

2 months ago


St Petersburg, United States Zelis Healthcare Full time
Job Title: Healthcare Business Analyst - Expert Claims Review

At Zelis Healthcare, we are seeking a skilled Healthcare Business Analyst - Expert Claims Review to join our team. This role is responsible for enabling high-quality user stories under our Expert Claims Review (ECR) product umbrella.

Key Responsibilities:
  • Gather requirements and acceptance criteria for ECR initiatives centered around handling medical pre-payment and post-payment claims for accurate claim payment review.
  • Provide documentation for system and process updates, as well as existing system functionality, for reference by operations and alternate teams.
  • Support training to operations on newly released items.
  • Recommend process, workflow, and efficiency improvements.
  • Communicate product development improvements and new product solutions being taken to market.
  • Draft and send release notes and organize user requirements; track and manage accordingly.
Qualifications:
  • Basic or advanced understanding of payment integrity, claim processing, and/or revenue cycle for healthcare claims.
  • Understanding of medical coding and medical claims.
  • Project Management experience; ability to drive output from others without direct supervisory responsibility.
  • Moderate to advanced experience with Microsoft Office Suite, JIRA, and Confluence.
About Zelis Healthcare:

Zelis Healthcare is modernizing the healthcare financial experience by providing a connected platform that bridges the gaps and aligns interests across payers, providers, and healthcare consumers. Our platform serves more than 750 payers, including the top 5 national health plans, BCBS insurers, regional health plans, TPAs, and self-insured employers, and millions of healthcare providers and consumers.

We are committed to diversity, equity, inclusion, and belonging in all aspects of our operations. We champion diversity and create an environment where people can bring their authentic and best selves to work. We know that a sense of belonging is key not only to your success at Zelis Healthcare but also to your ability to bring your best each day.

We are proud to be an equal opportunity employer and encourage members of traditionally underrepresented communities to apply. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email us.