Quality Business Analyst
The Quality Business Analyst Works in a production environment handling transactions required as well as providing business support to teams as needed.
Handle claims production tasks such as written inquiries and reconsiderations and related adjustments to attain FEP Performance metrics
· Ability to assess FEP procedures and regulations and required controls and incorporating what is required into the specifications and/or documentation.
· Identify process improvements and develop workflow and/or system recommendations.
· Support FEP audits, including research claims related issues/questions and preparation of appropriate audit responses as well as represent IBX in the audit presentation to FEP Directors Office, BCBSA, if needed.
· Support assigned projects related to FEP, maintain appropriate documentations at a task level, monitor deadlines and service as subject matter expert when appropriate.
· Develop and maintain user documentation/desk level procedures ensuring the most current information is available to the claims team
· Work with the Business Support team in reviewing FEP release documentation and participate in testing initiatives as needed.
· Communicate effectively in writing and verbally in work groups and with internal and external customers.
· Attend internal and external education training to achieve and maintain proficiency on all systems.
Qualifications
· High School Diploma or GED ,4 years’ experience in a Claims/Service operations environment OR Associate degree or minimum two-year Federal Employee Health Benefits Plan work-related experience, bachelor’s degree preferred.
· Knowledge of systems, process flows, regulatory impacts, and timelines to ensure requirements, testing and implementation are in compliance across operational disciplines.
· Excellent written and verbal communication skills are required to provide business units with information
· Maintain flexibility in a team environment and identify process improvement opportunities and define system impacts that may result.
· Experience in auditing, quality review or transaction processing experience
· Demonstrated understanding of FEP policies, processing standards and guidelines
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.
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.