Senior Business Analyst Claims Operations

2 days ago

Minneapolis, Minnesota, United States HealthEZ Full time $76,000 - $98,000

Job Details
Job Location:    Minnesota - Minneapolis, MN
Salary Range:    $ $ Salary/year

Description

The Opportunity

The Senior Business Analyst, Claims Operations is responsible for gathering facts, documenting requirements, performing all aspects of claims testing, and ensuring gaps and risks are mitigated to produce the expected claim outcomes within the required timeframes. The Senior Business Analyst will be part of the Plan Build team and report to the Director, Claims Operations.

What you'll do

  • Gather and develop business requirements to ensure claim processing produces the desired outcomes.
  • Build claim requirements and provide to other departments, vendors, and key stakeholders initiating other projects to ensure other stakeholders understand what the claims department needs to be successful.
  • Develop claim test scenarios, procedures, and plans.
  • Responsible for analyzing current business practices and systems and developing plans to optimize both practices and systems.
  • Document results, findings, options, and proposed solution(s) with comparison to current state and changes required.
  • Complete test procedures in the various test environments and upon test sign off validate specific outcomes continue within production.
  • Lead the Investigation of reported incidents, including performing root cause analysis, communicating with affected stakeholders, and designing and implementing internal controls to prevent similar incidents from occurring in the future.
  • Collaborate and coordinate with cross functional teams to identify and propose actionable solutions.
  • Accountable to resolve issues, defects and concerns related to testing.
  • Responsible for analyzing large data sets to find efficiencies and make recommendations on solutions to improve claims adjudication accuracy and timeliness.
  • Effectively communicate with team members, vendors, and stakeholders.
  • Oversee the test environments in collaboration with Plan build, IT and external vendors to ensure environment is refreshed and ready for successful execution of testing.
  • Document outcomes and train others on developed solutions.
Qualifications

What we expect from you

  • 3-5 years of Business Analyst experience supporting healthcare claims processing
  • BA degree or equivalent experience
  • Strong knowledge of Healthcare claims lifecycle
  • Virtual Benefits Administrator (VBA) knowledge or proven experience in learning claims adjudication platforms
  • Proven ability to effectively communicate with stakeholders
  • Self-starter and the ability to work independently

We make healthcare EZ

Additional Opportunity Details:

Target Base Compensation Range for this role is $78,000-$98,000K

* Factors that may be used to determine your actual salary include your job specific skills, education, training, job location, number of years of experience related to this role and comparison to other employees already in this role.

Employee benefits are part of the competitive total rewards package that HealthEZ provides to you. Our comprehensive benefits program includes health benefits, retirement plan (401k), paid time away, paid leaves (including paid parental leave) and more.

HealthEZ recognizes its responsibilities under federal, state, and local laws requiring non-discriminatory employment practices. All employment decisions, practices and procedures will be carried out without regard to race, color, creed, religion, sex (including pregnancy), sexual orientation, national origin or ancestry, age, marital status, disability, family status, status with regard to public assistance, or any other characteristic protected under applicable local, state, and federal laws.

HealthEZ is proud to be an equal opportunity employer.

  • Senior Business Analyst Claims Operations

    1 week ago

    Minneapolis, Minnesota, United States HealthEZ Full time $78,000 - $98,300 per year

    Job Details Minnesota - Minneapolis, MN Fully Remote $ $ Salary/year Description The OpportunityThe Senior Business Analyst, Claims Operations is responsible for gathering facts, documenting requirements, performing all aspects of claims testing, and ensuring gaps and risks are mitigated to produce the expected claim outcomes within the...

  • Medicaid Claims Analyst

    2 weeks ago

    Minneapolis, Minnesota, United States Russell Tobin Full time $43,000 - $56,500 per year

    JD-#E2EProfRussell Tobin and Associates is seeking an experienced Medicaid Claims Analyst for our global healthcare client working remotely in the United States. Candidates residing in EST or CST preferred.Job Title: Sr Capability Analyst - MedicaidPay: $43.00/hr. to $47.25/hr. (Based on experience)Schedule:Monday-Friday, DaysLocation:Remote CST or EST time...

  • Business Analyst

    2 weeks ago

    Minneapolis, Minnesota, United States Healthcare Support Staffing Full time $60,000 - $120,000 per year

    Company Description HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail...

  • Senior Financial Analyst

    2 weeks ago

    Minneapolis, Minnesota, United States CFS Full time $138,000 per year

    Job Title:Senior Financial AnalystLocation:Bloomington, MN (Hybrid)Salary:Up to $138K + 10% BonusOverviewThis Senior Financial Analyst role is an exciting opportunity for a finance professional who wants to make a direct impact on projects and operational performance. As a Senior Financial Analyst, you will work closely with project teams, operations, and...

  • Manager, Claims Operations

    7 days ago

    Minneapolis, Minnesota, United States Araz Group HealthEZ Full time $90,000 - $125,000 per year

    MANAGER, CLAIMS OPERATIONSThe OpportunityThe Manager, Claims Operations, leads all aspects of the claims adjudication process along with collaborating with other department leaders and vendor partners to deliver excellent service to our clients, members, and providers. This includes the development and execution of strategies and methodologies for efficient...

  • Manager, Claims Operations

    7 days ago

    Minneapolis, Minnesota, United States HealthEZ Full time $90,000 - $125,000 per year

    DescriptionMANAGER, CLAIMS OPERATIONSThe OpportunityThe Manager, Claims Operations, leads all aspects of the claims adjudication process along with collaborating with other department leaders and vendor partners to deliver excellent service to our clients, members, and providers. This includes the development and execution of strategies and methodologies for...

  • Senior Operational Risk Analyst

    2 weeks ago

    Minneapolis, Minnesota, United States RBC Full time $65,000 - $115,000 per year

    Job DescriptionJob Description SummaryThe Senior Operational Risk Analyst will be responsible for supporting Wealth Management U.S. (WM-U.S.) business and operational risk processes and initiatives, including execution of Operational Risk Management (ORM) standards in accordance with RBC Enterprise and combined U.S. Operations (CUSO), regulatory, industry,...

  • Claims Specialist

    1 week ago

    Minneapolis, Minnesota, United States Acro Service Corp Full time

    Job Title: Claim Processor/AnalystLocation: Minneapolis MNPay Rate: $38.9/hr on W2Job Summary:The Claims Management team is responsible for managing all aspects of claim processing and case management, while maintaining positive internal and external relationships with our dealers and customers. This role will also be responsible for performing analytics,...

  • Analyst, Business Operations

    4 days ago

    Minneapolis, Minnesota, United States Slalom Consulting Full time

    Who You'll Work WithSlalom is a purpose-driven consulting firm that helps companies solve business problems and build for the future, with solutions spanning business advisory, customer experience, technology, and analytics. We partner with companies to push the boundaries of what's possible—together.At Slalom, we are passionate about building a diverse...

  • Senior Financial Analyst

    6 days ago

    Minneapolis, Minnesota, United States Sun Country Airlines 2021 Full time

    About Sun Country Airlines We're not your average airline. We're agile, resilient, and full of uncommon opportunity. Here, you can grow as part of an ambitious team that safely and collectively supports each other, our travelers, and our community. Together, we're making travel more attainable. With more than 40 years of Minnesota roots, we're a unique...