Business Analyst

Position: Business Analyst

Location: Parsippany, NJ (Remote – need to travel to client place once in a month)

Duration: Full Time

Job Description:

Overview: As a Healthcare Business Analyst specializing in claims processing and pre-authorization, you will play a critical role in optimizing the development of our products. Your expertise will contribute to efficient claims management, accurate pre-authorization decisions, and streamlined processes.

Responsibilities:

• Analyze end-to-end claims workflows, from submission to payment.
• Collaborate with stakeholders (insurers, providers, patients) to identify process improvements.
• Understand how to Ensure compliance with industry standards (e.g., HIPAA)
• Evaluate pre-authorization requests for medical services or procedures.
• Verify medical necessity and adherence to guidelines.
• Facilitate timely approvals by working closely with providers and payers.
• Utilize tools like Excel, SQL, and data visualization platforms.
• Create reports, dashboards, and presentations to communicate insights.
• Monitor performance metrics related to claims and pre-authorization.
• Collaborate with IT teams to enhance products and development of claims processing systems.
• Gather requirements for system upgrades and new features.
• Maintain strong communication with cross-functional business units.

Benefits:

• Competitive salary
• Health insurance coverage
• Retirement plans
• Professional development opportunities