Job Description

Healthcare Business Analyst

Elite Technical is seeking a Business Analyst for our Healthcare Insurance client in the Maryland/BWI area. The selected candidate will be responsible for facilitating the creation, implementation, maintenance and optimization of the various Information Technology (IT) and non-IT related processes. The selected candidate will collaborate with development leads, account managers, and business users with the purpose of designing, building, documenting and assisting with testing solutions for data interchange and business processes. The person must be able to multi-task and work in a fast-paced environment. This role will collaborate and coordinate activities with diverse groups, including stakeholders, sponsors, team leads, vendors, project managers, and technical staff; producing high quality documentation artifacts; and a sound working understanding of IT concepts and the IT design & delivery life cycle.

This individual will work with transactional data including inbound and outbound HIPAA transactions, i.e. 834, 837, 835 as well as proprietary files, including data extracts. This position will be responsible for system analysis, as it pertains to configuration to the claims system, including but not limited to core business operation applications. The individual will interface with all levels of the Health Plan and will recommend operational solutions based on system capabilities and business needs. The incumbent will also be responsible for creating and maintaining documentation and validation to support proposed solutions.

Want to learn more about this fulltime/direct opportunity with our client? Then you should contact Elite Technical right away for consideration!

Required Skills

- B.S. degree in Business, Economics, Public Health or Computer Science is preferred
- Minimum 3 years of experience in business analysis, requirements definition and deployment of business requirements to information systems within a Healthcare Insurance Payor organization.
- Thorough understanding of all aspects of claims processing systems - including (but not limited to) claim adjudication, membership and enrollment, eligibility, configuration and benefits, authorizations and payment.
- Must have HIPAA transactions (834 and 837 are required. 278, 835 is a plus) as well as proprietary files, including data extracts
- Microsoft Visio and/or SmartSheets is required
- Must be able to construct and execute SQL queries for data extraction purposes
- Must be able to translate technical requirements to functional specifications, and vice versa
- Must possess good verbal and written communication skills; and, have the ability to render and write business requirements as technical documentation and business decision documentation.
- Proficiency in requirements gathering - effectively translating business needs as expressed by users into workable specs, estimating time\duration to complete and implement the solution.
- Experience with developing traceability matrix, to be used in software development and testing, is a plus. Must be comfortable working with testing teams.
- Excellent technical, analytical, and communication skills.

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Job Tags

Full time,

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