Claims Business Analyst I

Company: Medica
Location: Minnetonka
Posted on: June 6, 2021

Job Description:

Claims Business Analyst I gathers, researches, and documents requirements from business stakeholders. Design, develop, implement, and maintain of new deliverables, processes, or models. Responsible for operationalizing regulatory and/or business requirements, including process improvement and work related to growth initiatives. This is an entry level professional position. Basic, structured, standard approach to work. Performs professional responsibilities with direct supervision on method and processes.

Job Duties include:

Track and document the inquiries from others both internal to our business area and outside our business area to maintain visibility to system "asks"

Develop relationship with Enterprise and IT BA staff

Analyze and Identify system changes, compliance or other business initiatives that may impact business and:

• Engage management and key staff to gather input and feedback
• Document and maintain discussions and decisions

Coordinate on behalf of, and/or attend in BA related representation of claims operations activities at IT and business operations related meetings (schedule, prepare agenda in advance of meeting, maintain meeting documentation, discussions, decisions, store centrally, etc.)

Analyze, identify gaps and impacts, coordinate and guide operations staff through processes to prepare for, communicate and implement claims operations related projects and system changes.

Maintain visibility of system needs, updates, changes, work, etc. to Claims Operations management and teams:

• Tracking of projects and project work
• Weekly communications to Managers and supervisors:
• Project Updates (status of business readiness, testing outcomes, successes and challenges)
• Project Needs - Resources, Business decisions
• Upcoming projects - updates to learned or known future project work or systems changes
• Priority of projects

Coordinate and conduct UAT and business validation testing efforts:

Develop procedures and guidance to staff of business validation testing [may be referred to as user acceptance testing (UAT)]

Coordinate the development of and/or provide test plan templates to use for ongoing testing activities in Claims Operations

Monitor testing activities

Report issues to IT Report issues identified

Expedite relay of issues to IT and IT directed actions or resolutions back to employees conducting Business Validation testing

Qualifications:

• Bachelor's degree in related field or equivalent experience

Preferred Qualifications:

• Knowledge and experience with general Claims Operations billing and submission processes and guidelines.
• Knowledge of and experience with claims paid through Government programs (Medicare Cost and Supplemental Plans, Medicare Advantage, Medicaid, etc.)

Keywords: Medica, Minnetonka , Claims Business Analyst I, Other , Minnetonka, Minnesota