Business Analysis Associate II

Quest Diagnostics is a leading provider of diagnostic information services, and they are seeking a Business Analysis Associate II to optimize the order-to-cash cycle for Oncology and Clinical clients. This role involves managing complex billing data, conducting audits, resolving claim discrepancies, and collaborating with various teams to enhance the billing experience.

Responsibilities:

• Utilize complex data queries from multiple sources to perform quality checks, conduct trend analyses, and deliver predictive/prescriptive insights on operational billing data
• Conduct robust billing audits and quality assurance checks to verify source data, reconcile invoice discrepancies, and ensure accurate payer routing
• Investigate and resolve non-standard billing issues, manage denied claims through to completion, and analyze root causes to prevent future discrepancies
• Partner with the Specialty Testing and PODSS teams to align client expectations, facilitate resolutions, and escalate complex account matters when necessary
• Develop training materials and conduct educational sessions for internal teams and external payers regarding new billing processes, regulatory changes, or system enhancements
• Maintain strict adherence to state, federal, and organizational billing policies while leveraging audit results to drive downstream operational and system efficiency

Requirements:

• 2+ year of experience in RCM/finance analysis collecting, analyzing, and presenting data and recommendations to management
• 2+ years of experience with insurance billing, follow-up, and/or denials
• Experience trending, analyzing, and evaluating third party insurance responses in a medical billing environment
• QBS/WBS experience
• Ability to perform “root cause analysis” to assess insurance denials
• Excellent communication, time/project management, problem solving, organizational, and analytical skills
• Intermediate level of proficiency with PC based software programs and automated database management systems (Excel, Access, PowerPoint)
• Demonstrated process improvement, workflow, benchmarking and / or evaluation of business processes
• Sitting/standing for long periods of time
• Potential client visits require reliable mode of personal transportation
• Bachelor's degree in Business, Finance, Health Administration or related field
• Working knowledge of SQL or other Big Data sources