Job Description

ROLES & RESPONSIBILITIES Job Responsibilities We need a business analyst/business Advisor with experience in regulatory compliance, state fee schedule and in any medical bill review engine or platform. Also, strong understanding of medical claims bill review cycle Provide and support the implementation of business solutions identifying business needs determining and carrying out necessary processes and practices monitoring progress and results recognizing and capitalizing on improvement opportunities and adapting to competing demands, organizational changes and new responsibilities Identify, create and facilitate process design changes by conducting business and systems process analysis and design at a complex level focusing on quality improvement and data management ensuring data is reliable and valid developing process improvements or re-engineering and recommending elimination Provide project level analysis producing required project analysis documentation (business requirements, scope matrix, use cases, sequence diagrams, future state proposals, UAT plan) Provide leadership to team members and peers by collaborating with others articulating ideas and viewpoints to senior management, peers and others identifying and initiating projects managing resources driving the resolution of issues and holding self and team accountable for results Collaborate closely with developers to implement the requirements, provide necessary guidance to testers during QA process Identify improvement opportunities (proactive and reactive) Elicit and clearly document business and systems requirements Assess business process and system inefficiencies Identify ways to increase adoption and customer satisfaction Demonstrated fluency in business processes and process differentiation Ability to analyze and synthesize business requirements, including recognizing patterns and conceptualizing processes Requirements: 10-12 years of experience as Business Analyst Should have atleast 6 years of experience in US Healthcare and insurance industry Experience in regulatory compliance, state fee schedule Experience in any medical bill review engine or platform and strong understanding of medical claims bill review cycle Must have experience working on large scale projects as well as handling day-to-day operational requests from the business Strong project management, ability to successfully manage multiple tasks at any given point, strong relationship building skills & communication skills

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