Title : Payer Claim Business Analyst
Job Summary
We are seeking an experienced Healthcare Payer Claim Business Analyst to join our team. The successful candidate will play a key role in analyzing and improving claims processing, ensuring compliance with regulatory requirements, and driving business growth.
Key Responsibilities
1. Analyze claims data to identify trends, issues, and opportunities for process improvements.
2. Collaborate with stakeholders to understand business requirements and develop solutions to improve claims processing efficiency and accuracy.
3. Design and implement data analytics and reporting to track key performance indicators (KPIs) and monitor claims processing.
4. Conduct root cause analysis of claims issues and develop corrective action plans.
5. Develop and maintain documentation of claims processes, procedures, and policies.
6. Collaborate with cross-functional teams, including claims processing, underwriting, and provider relations.
7. Stay up-to-date with regulatory changes and industry trends impacting claims processing.
Requirements
1. Minimum 3-5 years of experience in healthcare claims processing or business analysis.
2. Strong analytical and problem-solving skills.
3. Excellent communication and interpersonal skills.
4. Experience with data analysis and reporting tools (e.g., SQL, Excel)
5. Knowledge of healthcare claims processing regulations (e.g., HIPAA, CMS).
6. Certification in healthcare analytics or business analysis (e.g., CBAP, CCBA) a plus.
Skills
1. Strong analytical and problem-solving skills.
2. Excellent communication and interpersonal skills.
3. Ability to work in a fast-paced environment.
4. Strong attention to detail.
5. Experience with project Management
...leading companies, bringing solutions and enhancing customer experience during each interaction. We are the... ...in the market: multicultural, highl Customer Service Representative, Customer Service, Healthcare, Work From Home, Representative, Customer Experience, Technology...
...Job Description Nortek Medical Staffing, Inc. is seeking a Nurse Practitioner Outpatient Family Practice for a job in Roxboro, North Carolina. Job Description & Requirements ~ Specialty: Family Practice ~ Discipline: Nurse Practitioner ~ Duration: Ongoing...
...Title: Standardized Patient Division: Provost's Office Department: Kinney College of Nursing & Health Professions FLSA Status: Non-Exempt Salary Range: $13.31/hour EEO Job Group: 2 C8 Position Summary To realistically portray different types...
...Job Description Bookkeeper Who We Want Evolve is seeking a reliable and detail-oriented Bookkeeper to support the finance team... ...English Flexibility in work schedule (e.g., evenings and weekends as needed) Must be eligible to work in the United States...
...Affordable Landscaping Services is looking for Remote Data Entry Clerks to support our growing operations team. This is a 100% work-from-home position suitable for entry-level candidates, fresh graduates, and individuals looking for flexible remote work. You will...