Overview
Skills
Job Details
Our direct client is seeking a Business Analyst
Bachelors degree is required. BA Certifications and or PMP is a plus.
4+ years of BA experience in onboarding new self-funded clients or implement product in Multi-employer Trust or Health Plan Administration.
4+ years of Eligibility and Enrollments, Administration of Plans, Benefits, claims, accumulators, Provider Finder.
Must have experience with have experience with the -hours intake- process AND eligibility calculations.
Experience with SFTP, EDI X12 transactions 834, 837, 270/1 is a plus.
Ability to adapt to a fast pace, changing environment and to handle changing priorities and deadlines.
Skilled at persuasive written and verbal communications that drive action or set strategic direction
Proficient in Microsoft Office including Outlook, Excel, Visio, PowerPoint and Word.
Knowledge of BA/ MS project Tools, JIRA, MS Project.
Able to manage large scale initiatives.
Skilled at large JAD type sessions and interviews and be able to document SMART requirements for consumption by technical teams.
Need to have a commanding the room type personality to drive their work and facilitate conversations.
Ability to manage multiple stakeholders from different business areas both technical and business.
Familiar with assumptions, dependencies, defining what is in and out of scope.
Seeking candidates with the following expertise:
Client implementations/client-facing related experience/vendor integrations (as a BA)
Eligibility/Enrollment experience (retro enrollment and retro termination knowledge)
Adjudication of Claims business logic
Member communication in Commercial
TPA/ ASO