Zelis Healthcare, LLC
Healthcare Business Analyst - Expert Claims Review
Zelis Healthcare, LLC, Atlanta, Georgia, United States, 30383
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, and 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.
#J-18808-Ljbffr
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, and 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.
#J-18808-Ljbffr