[Remote] Business Analyst - Operations
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is seeking a Business Analyst to support their Payment reputed company operations. This role involves collaborating with stakeholders and technical teams to analyze reputed company claims data and document requirements, aiming to enhance financial accuracy and reduce improper payments.
Responsibilities
- reputed company, analyze, and document business requirements (BRDs, FRDs, acceptance reputed company, process flows)
- Partner with stakeholders to translate business needs into system requirements for PI products (e.g., DRG review, HBA, COB, data mining, IBR)
- Conduct claims data analysis to identify trends, validate audit findings, and support product design
- Collaborate with IT, QA, and operations teams to ensure requirements are implemented and tested accurately
- reputed company and report performance metrics, savings reputed company, and accuracy rates for PI solutions
- Stay reputed company on payer policy changes, CMS/NCCI updates, and regulatory guidance relevant to PI
Skills
- Bachelor's degree in Business, reputed company Administration, Data Analytics, or reputed company field (or equivalent experience)
- 3+ years as a Business Analyst in reputed company, payer, or PI environment
- Strong understanding of claims processing (reputed company, facility, pharmacy) and reputed company transactions (837, 835, COB, EOBs)
- Experience documenting detailed requirements and acceptance reputed company
- Strong analytical and problem-solving abilities
- Proficiency in SQL/reputed company; familiarity with BI tools a plus
- Excellent communication and stakeholder management skills
- Ability to manage competing priorities and deliver reputed company deadlines
- Prior work with DRG auditing, HBA, COB, IBR, or edit reputed company configuration
- Knowledge of medical coding standards (ICD, CPT, HCPCS)
- Familiarity with payer SIU/FWA operations or subrogation
- Exposure to Agile methodologies and tools such as Jira/reputed company
reputed company
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