Title : Payer Claim Business Analyst
Job Summary
We are seeking an experienced Healthcare Payer Claim Business Analyst to join our team. The successful candidate will play a key role in analyzing and improving claims processing, ensuring compliance with regulatory requirements, and driving business growth.
Key Responsibilities
1. Analyze claims data to identify trends, issues, and opportunities for process improvements.
2. Collaborate with stakeholders to understand business requirements and develop solutions to improve claims processing efficiency and accuracy.
3. Design and implement data analytics and reporting to track key performance indicators (KPIs) and monitor claims processing.
4. Conduct root cause analysis of claims issues and develop corrective action plans.
5. Develop and maintain documentation of claims processes, procedures, and policies.
6. Collaborate with cross-functional teams, including claims processing, underwriting, and provider relations.
7. Stay up-to-date with regulatory changes and industry trends impacting claims processing.
Requirements
1. Minimum 3-5 years of experience in healthcare claims processing or business analysis.
2. Strong analytical and problem-solving skills.
3. Excellent communication and interpersonal skills.
4. Experience with data analysis and reporting tools (e.g., SQL, Excel)
5. Knowledge of healthcare claims processing regulations (e.g., HIPAA, CMS).
6. Certification in healthcare analytics or business analysis (e.g., CBAP, CCBA) a plus.
Skills
1. Strong analytical and problem-solving skills.
2. Excellent communication and interpersonal skills.
3. Ability to work in a fast-paced environment.
4. Strong attention to detail.
5. Experience with project Management
...Allegheny Health Network (AHN) Pediatric Institute is recruiting a Pediatric Gastroenterologist to join our growing pediatric specialty network in Pittsburgh, Pennsylvania. Highlights: Primary care pediatric network that encompasses over 80,000 covered lives...
...BAR MANAGER- NEW OPENING - JKS RESTAURANTS Schedule - Full Time Experience - Previous experience as a Bar Manager in a high quality restaurant or cocktail bar. (Michelin Starred experience a bonus). Ambassadors Clubhouse NYCis seeking a Bar Managerto lead on...
...information you submit will be provided solely to the franchisee. If hired, the franchisee will be your only employer. Franchisees are independent business owners who are solely responsible for their own employees and set their own wage and benefit programs that can vary...
POSITION SUMMARY : Reporting to the Administrative Director of Neurology plans, develops, directs and control the operation of the Applied Neurophysiology /Laboratory to ensure timely and high quality EEG studies wherever they are needed in the hospital and whenever...
...Verify that all drivers maintain valid CDL credentials, passenger endorsements, medical... ...Minimum of 3 years of licensed driving experience. Clean MVR meeting the following guidelines... ...protected by federal, state or local law. No question in our application process...