Job Description
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.
Role Description
- This role involves transforming healthcare administration by effectively capturing business requirements to support health plan operations.
- Lead business requirement conversations with customers and internal teams.
- Manage end-to-end requirements involving all stakeholders.
- Develop business and functional requirements for Claims, Enrollment, Provider, Authorization, and Payment systems.
- Create solutions to improve current business processes using core-admin ecosystem.
- Negotiate with clients to develop applicable processes.
- Qualifications
- Bachelor's degree or higher in a business or technical field.
- 7+ years of relevant work experience in business analysis.
- Knowledge of Healthcare insurance domain (Medicare, Medicaid, etc.).
- Experience with mapping EDI healthcare transactions (837, 834, 835, etc.).
- Ability to translate business requirements into technical requirements in EDI.
- Experience documenting requirements or user stories for technical teams.
- Experience in onshore/offshore model is essential.
- Familiarity with HealthEdge applications is a plus.
- Understanding of SQL and XSDs is advantageous.
- Proficient in Agile tools and methodologies.
- Benefits
- Accrue up to 16 days of paid vacation per year.
- Receive 6 days of paid sick leave each year.
- Enjoy 10 paid holidays annually.
- Eligible for paid bereavement leave.
- Participate in a 401(k) Retirement Plan with employer matching.
- Eligible for medical, dental, and vision insurance.
- Receive Company-paid life, disability, and accidental death benefits.
- Ability to purchase additional short-term disability benefits.
- Potential for quarterly incentive bonuses depending on the role.
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