Zelis
Healthcare Business Analyst - Expert Claims Review
Zelis, Trenton, New Jersey, United States,
Position Overview
At Zelis, the Business Analyst - Expert Claims Review (ECR) is ultimately responsible for enabling high quality user stories under our ECR product umbrella. This includes Itemized Bill Review, Clinical Chart Review, Dialysis Savings Solution and DRG Validation solutions.
In this role, you will work as part of the Product team to facilitate clear and open communication between Business Owners, Scrum/Development, Quality Assurance, UAT and Product Owners. This role provides a major contribution to source technological improvements, process improvements, enhancements to workflow, ultimately enhancing Zelis’ overall capacity to meet the information technology needs of an ever-changing payment integrity market.
Key Responsibilities
Gather requirements/acceptance criteria for Expert Claims Review initiatives centered around handling of medical pre-payment and post-payment claims for accurate claim payment review through our suite of solutions.
Provide documentation for system/process updates and existing system functionality for reference by operations and alternate teams.
Support training to operations on newly released items.
Recommend process, workflow and efficiency improvements.
Communicate product development improvements and new product solutions being taken to market.
Draft and send release notes and organize user requirements; track and manage accordingly.
Qualifications
Basic or advanced understanding of payment integrity, claim processing and/or revenue cycle for healthcare claims.
Understanding of medical coding and medical claims.
Project Management experience; ability to drive output from others without direct supervisory responsibility.
Moderate to advanced experience with Microsoft Office Suite, JIRA + Confluence.
Location and Workplace Flexibility:
We have offices in Atlanta GA, Boston MA, Morristown NJ, Plano TX, St. Louis MO, St. Petersburg FL, and Hyderabad, India. We foster a hybrid and remote friendly culture and all of our employee's work locations are based on the needs of the position and determined by the Leadership team.
Commitment to Diversity, Equity, Inclusion, and Belonging
At Zelis, we champion diversity, equity, inclusion, and belonging in all aspects of our operations. We embrace the power of diversity and create an environment where people can bring their authentic and best selves to work.
Equal Employment Opportunity
Zelis is proud to be an equal opportunity employer. All applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
Accessibility Support
We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email TalentAcquisition@zelis.com.
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At Zelis, the Business Analyst - Expert Claims Review (ECR) is ultimately responsible for enabling high quality user stories under our ECR product umbrella. This includes Itemized Bill Review, Clinical Chart Review, Dialysis Savings Solution and DRG Validation solutions.
In this role, you will work as part of the Product team to facilitate clear and open communication between Business Owners, Scrum/Development, Quality Assurance, UAT and Product Owners. This role provides a major contribution to source technological improvements, process improvements, enhancements to workflow, ultimately enhancing Zelis’ overall capacity to meet the information technology needs of an ever-changing payment integrity market.
Key Responsibilities
Gather requirements/acceptance criteria for Expert Claims Review initiatives centered around handling of medical pre-payment and post-payment claims for accurate claim payment review through our suite of solutions.
Provide documentation for system/process updates and existing system functionality for reference by operations and alternate teams.
Support training to operations on newly released items.
Recommend process, workflow and efficiency improvements.
Communicate product development improvements and new product solutions being taken to market.
Draft and send release notes and organize user requirements; track and manage accordingly.
Qualifications
Basic or advanced understanding of payment integrity, claim processing and/or revenue cycle for healthcare claims.
Understanding of medical coding and medical claims.
Project Management experience; ability to drive output from others without direct supervisory responsibility.
Moderate to advanced experience with Microsoft Office Suite, JIRA + Confluence.
Location and Workplace Flexibility:
We have offices in Atlanta GA, Boston MA, Morristown NJ, Plano TX, St. Louis MO, St. Petersburg FL, and Hyderabad, India. We foster a hybrid and remote friendly culture and all of our employee's work locations are based on the needs of the position and determined by the Leadership team.
Commitment to Diversity, Equity, Inclusion, and Belonging
At Zelis, we champion diversity, equity, inclusion, and belonging in all aspects of our operations. We embrace the power of diversity and create an environment where people can bring their authentic and best selves to work.
Equal Employment Opportunity
Zelis is proud to be an equal opportunity employer. All applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
Accessibility Support
We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email TalentAcquisition@zelis.com.
#J-18808-Ljbffr