Healthcare Business Analyst

Job Description: • Seeking strong Business Analyst to support BlueCard daily operations. • This support will assist to move forward resolution of operational challenges, improve current processes and support project management initiatives. • You will work closely with other team members and cross functional teams such as configuration and Account Management to resolve discrepancies and improve claims processing experience for BlueCard members • Support the processing team with analysis of claim issues and inquiries. Perform root cause analysis and course correct identified issues for full resolution. • Work with other plans to resolve issues for members • Research root cause of incorrectly processed claims, failed DF and RFs. Provide solution and coordinate with appropriate team members to repair the claim and provide re-education to the processor or submit ticket for system enhancement. • 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 with pulling needed data and assist with the documentation of processes and work procedures. • Represent Department as SME in meetings, projects and company initiatives • Communicate with other plans via the Blue Squared BCBSA Application (RTM) • Advanced skills in Microsoft Office and with Microsoft platforms (e.g. Excel, Word, PowerPoint) is required • Working experience with SQL and Access is required. • Tableau experience is preferred • Experience with technologies, desktop tools and or Operations processes and technology is helpful • Perform other duties as assigned. Qualifications: • Experience: 3 years or more of experience in medical claims processing and adjusting or healthcare administration. Expertise in the Blue Squared application • Technical Skills: Knowledge of medical billing codes (ICD-10, CPT, HCPCS), claims processing software, and a strong understanding of the BlueCard product. Ability to summarize large amounts of data and pivot data in multiple ways • Analytical Skills: Ability to assess claim data in detail and identify errors or inefficiencies. Possess excellent mathematical skills and have the ability to work independently and within tight timeframes. • Communication Skills: Strong written and verbal communication skills for interacting with various stakeholders and resolving issues quickly • Attention to Detail: High level of accuracy and thoroughness in reviewing claims for clients Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app