Lead Analyst

Lead Business Analyst

Lead Business Analyst will be responsible for defining business intent, business requirements, functional requirements, non-functional requirements, data mapping, system/process impacts, and participate in issue assessment for client Claims and Audit processes and systems, starting in client Claims Electronic Data Interchange (EDI) functional area. Lead analyst will also provide feedback and guidance to more junior members of the team.

Position Requirements:

8-11 Years Experience

Excellent demonstrated analytical skills applied to business software solutions maintenance and/or development.

Knowledge of health care claims adjudication processes, logic and data

Extensive hands-on X12 health care insurance transaction (834, 837, 270, 271, etc.) data mapping and issue resolution experience

Knowledge of the software development standards and practices.

Demonstrated ability to find efficiencies and improve processes.

Proven ability to determine systemic process faults and improve overall process performance across organizations.

Understanding of claims adjudication, particularly in a health care environment

Understanding of health industry diagnosis, procedure and revenue codes and their application

Excellent business analytical skills.

Excellent process analysis skills

Excellent process documentation skills

Excellent communication/writing skills,

Excellent interpersonal skills

Attentive to detail, highly-organized, and able to multi-task

Ability to work independently and meet deadlines

Preferred:

Experience with claims adjudication in the client system.