Alpha Business Solutions LLC
Alpha Business Solutions LLC

Business Analyst - Medical Claims Processing | Contract-to-Hire | Philadelphia - Hybrid

Philadelphia, PA, US • Posted 1 day ago • Updated 1 day ago
Contract W2
24 Months
On-site
Depends on Experience
Fitment

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Job Details

Skills

  • MEDICAL CLAIMS PROCESSING
  • HEALTHCARE ADMINISTRATOR

Summary

Job Title: Business Analyst AHA
Philadelphia, PA 19103 - Hybrid 0(Tues, Wed, Thurs in office / Mon, Fri remote)
Contract-to-Hire | Will convert to full-time in 3 months
Pay rate: $45/HR - $52/HR W2 (negotiable)
 
Job Description
Seeking strong Business Analyst to support claims daily operations. This support will assist to move forward resolution of operational challenges, improve current processes and support project management initiatives. You will work closely with other team members and cross functional teams such as configuration and Account Management to resolve discrepancies and improve claims processing experience for members.
  • Support the processing team with analysis of claim issues and inquiries. Perform root cause analysis and course correct identified issues for full resolution.
  • Research root cause of incorrectly processed claims.. Provide solution and coordinate with appropriate team members to repair the claim and provide re-education to the processor or submit ticket for system enhancement.
  • Focus on applying technologies to continuously increase claims process improvements with the use of data, Bots and applications/tools.
  • Share this knowledge and skill with other team members to instill across the team the opportunities that they can escalate to process improve. Schedule reoccurring meetings to keep momentum.
  • Responsible for evaluating current business processes and developing, implementing, testing and maintaining Technology for more cost effective or quality improvement processing.
  • Assist with pulling needed data and assist with the documentation of processes and work procedures.
  • Represent Department as SME in meetings, projects and company initiatives
  • Advanced skills in Microsoft Office and with Microsoft platforms (e.g. Excel, Word, PowerPoint) is required
  • Working experience with SQL and Access is required.
  • Tableau experience is preferred
  • Experience with technologies, desktop tools and or Operations processes and technology is helpful
  • Perform other duties as assigned.
 
Qualifications – External
  • Experience: 3 years or more of experience in medical claims processing and adjusting or healthcare administration. 
  • Experience working with health systems in the billing revenue space working with health system provider data, and medical claims administration.  
 
Technical Skills:
  • Knowledge of medical billing codes (ICD-10, CPT, HCPCS), claims processing software.  Ability to summarize large amounts of data and pivot data in multiple ways
Analytical Skills: Ability to assess claim data in detail and identify errors or inefficiencies. Possess excellent mathematical skills and have the ability to work independently and within tight timeframes.
Communication Skills: Strong written and verbal communication skills for interacting with various stakeholders and resolving issues quickly
Attention to Detail: High level of accuracy and thoroughness in reviewing claims for clients
 
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.
 
 Please apply with your interest. You may also reach out to me at
 
Thank you,
Ashu
 
We provide a comprehensive package which includes.
Benefits
  • Medical for full time employees
  • Dental, and Vision Insurance
  • Life Insurance, Short-Term Disability, Long-Term Disability, etc.
Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.
  • Dice Id: 91140885
  • Position Id: 26-00283
  • Posted 1 day ago
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