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Please note: Only considering candidates with extensive experience with the below Must have Strong Healthcare Domain background Strong experience with Claims Adjudication and Claims processing Strong experience with EDI processes, 837, 834, 270, 271, 835 etc Position Purpose:
Senior Business Analyst will be responsible for researching, writing requirements (including data mapping), and sharing information with Plans on FEPOC EDI changes. May at times need to write business intent, business requirements, functional requirements, non-functional requirements, and system/process impacts for Claims and Audit processes and systems.Position Requirements:8 - 10 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 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 deadlinesPreferred: Experience with claims adjudication in the Federal Employee Program Health Benefit Plan Experience in a software application development environment in an analytical role Bachelors (Health administration; business administration; software engineering or related degree required)