Job Description :

Lead HealthCare Business Analyst ( Bay Area California , Remote)

Contract : 12 Months

Exp :15+ ears 

Job Responsibilities

  • Understands and applies basics of business process management.
  • Collaborate on projects as required with project manager and project sponsor.
  • Can produce basic process related document.
  • Collaborates closely with system, claims, Integration and data warehouse teams to design EDI system solutions related to claims, encounters, and reporting processes. 
  • Participate in the building and implementation of effective EDI solutions by ensuring data quality, data completeness and data accuracy
  • Participate in gathering, analyzing requirements and develops processes to meet business requirements. 
  • Update trading partners in claims processing software for EFT/835. 
  • Actively works with team members in projects related to EDI file formats (837, 835, 277, 278). 
  • Performs monitoring and troubleshooting of EDI transactions. 
  • Supports Business Performance Specialists and Managers; may lead sub-teams, but does not lead project teams. May be involved with larger process efforts in a support role.
  • Requires guidance from manager.
  • This role will be tactical and operational in nature. There will be opportunities for independent work but a majority of the activities will be based upon directions by others.
  • The role will need to be able to analyze and present a summary of findings related to processes and performance.
  • A working understanding of how systems and data interact is necessary.

Required Experience

  • Thorough understanding of various EDI File Format (837, 835, 277, 278)
  • Detail knowledge about claims and Encounter creation.
  • Experience of dealing with various trading partners and/or clearing houses.
  • Has participated on a project team or performance improvement initiative.

Professional Skills

  • Basic SQL knowledge
  • Demonstrated ability to facilitate workshops and lead meetings with a large, diverse stakeholder participation. Demonstrated ability to understand, interpret and visualize processes.
  • Proficient with MS Office Suite, MS Visio (or equivalent diagramming tool), and collaboration tools.


Client : KAnand

             

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