Business Analyst II

Role Overview

• Serving as a liaison, the BA II works closely with Health Plans and their staff to address workflow inquiries
• Responsible for researching and maintaining comprehensive documentation, such as policies, manuals, and contracts
• Crafts validation instructions to guide downstream departments in accurately reviewing claims related to overpayment scenarios
• Manage Ad Hoc recovery initiatives and handle monthly low-complexity recurring leads
• Analyzing recovery reports to enhance claim validation accuracy and identify areas for process improvement

Requirements

• Requires a BA/BS
• minimum of 3 years related business analysis experience
• Experience with Medicaid, Medicare, Commercial lines of business preferred
• Claims Processing Experience is a must
• COB experience strongly preferred
• Data analysis experience preferred
• GBD FACETS experience preferred
• WGS experience nice to have
• Attention to detail strongly preferred

Benefits

• merit increases
• paid holidays
• Paid Time Off
• incentive bonus programs
• medical benefits
• dental benefits
• vision benefits
• short and long term disability benefits
• 401(k) +match
• stock purchase plan
• life insurance
• wellness programs
• financial education resources