Business Analyst AHA
Business Analyst is needed to support daily operations for provider/claim team. This critical work will assist move forward resolution of operational challenges, improve current processes, support project management initiatives.
· Support the provider/claim operations team with analysis of provider data structure issues, related claim payment, benefit network maintenance and provider demographic structure. Perform root cause analysis and course correct identified issues for full resolution.
· Research root cause of failed payments to determine if it is Provider related. If so, provide solution and coordinate with appropriate team members to repair provider record, pull claims for reprocessing through the bots and ensure payments are reissued correctly (working with Provider File Support, Claims and Issue Management teams). Provide updates to Provider Relations as necessary for escalated claims.
· 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 pulling needed data and in the documentation of processes and work procedures.
· Perform other duties as assigned.
- Advanced skills in Microsoft Office and with Microsoft platforms (e.g. Excel, Word, PowerPoint) is required; working experience with SQL and Access preferred. Experience with technologies, desktop tools and or Operations processes and technology is helpful
Qualifications
Education
- Bachelor's Degree in Business, Computer Science, Mathematics, Information Systems or equivalent work experience preferred
Experience
Knowledge, Skills, Abilities
- Highly self-motivated, highly organized and detailed oriented as well as above average problem solving, analytical, and verbal and written communication skills are required.
- Must have a general understanding of the business environment and associated systems with experience interfacing with Management and awareness of current trends in Technology.
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.
Inclusion and Belonging
At IBX, everyone can feel valued, supported, and comfortable to be themselves, and all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. Celebrating and embracing diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
About Our Company
Serving more than 8 million people nationwide, including 2.5 million in southeastern Pennsylvania, Independence Health Group — together with its subsidiaries — is the leading health insurance organization in the Philadelphia region. Our mission to build healthier lives for you, your family, and your employees shapes our actions and decisions every day.
At Independence, we see each of our members as an individual, with unique needs and concerns. We’re dedicated to harnessing the very latest ideas and technologies to deliver access to care that meets those needs and surpasses your expectations. For more information about Independence access our website at www.ibx.com. We’re revolutionizing health care, and our focus is on you!
Equal Employment Opportunity
IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Agency Disclaimer
All resumes submitted directly to an Independence Blue Cross employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of Independence Blue Cross and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by Independence Blue Cross or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process.