Lead Healthcare Claims Business Analyst

System One
Washington, DC
24 Jun 2024

Vacancy expired!

ALTA IT Services is staffing a long-term contract for a Lead Business Analyst to join a leading health insurance customer.

Lead Healthcare Claims Business Analyst Washington, DC (Currently 100% Remote, Hybrid after COVID) 12+ Month Contract

Lead Business Analyst will be responsible for researching, writing requirements (including data mapping), and sharing information with Plans on clients EDI changes. May at times need to write business intent, business requirements, functional requirements, non-functional requirements, and system/process impacts for client's Claims and Audit processes and systems. Lead analyst will also provide feedback and guidance to more junior members of the team.

8-11 Years Experience • Strong demonstrated analytical skills applied to business software solutions maintenance and/or development. • Knowledge of health care claims adjudication processes, logic and data • Extensive hands-on X12 health care insurance transaction (834, 837, 270, 271, etc.) data mapping and issue resolution experience • Knowledge of the software development standards and practices. • Demonstrated ability to find efficiencies and improve processes. • Proven ability to determine systemic process faults and improve overall process performance across organizations. • Understanding of claims adjudication, particularly in a health care environment • Understanding of health industry diagnosis, procedure and revenue codes and their application • Strong business analytical skills. • Strong process analysis skills • Strong process documentation skills • Excellent communication/writing skills, • Excellent interpersonal skills • Attentive to detail, highly-organized, and able to multi-task • Ability to work independently and meet deadlines

Preferred: • Experience with claims adjudication in the Health Benefit Plan • Bachelors (Health administration; business administration; software engineering or related degree required)