Business Analyst - ECR

Company: Zelis Healthcare, LLC
Location: Saint Petersburg
Posted on: April 16, 2024

Job Description:

Position OverviewAt Zelis, the Business Analyst - ECR is ultimately responsible for enabling high quality user stories under our Expert Claims Review (ECR) product umbrella, which consists of Itemized Bill Review, Clinical Chart Review, Dialysis Savings Solution and DRG Validation solutions. User story sourcing and generation will be expected to be done by being a self-starter and gathering acceptance criteria from multiple stakeholders in the business, using a keen analytical ability while also working in an Agile framework that delivers valued business outcomes and informed decisions for Zelis' key stakeholders for our solution umbrella. The Business Analyst works as part of the Product team to facilitate clear and open communication between Business Owners, Scrum/Development, Quality Assurance, UAT and Product Owners. This role provides a major contribution to source technological improvements, process improvements, enhancements to workflow and ultimately enhancing Zelis' overall capacity to meet the information technology needs of an ever-changing payment integrity market.Key Responsibilities

• Gather requirements/acceptance criteria for Expert Claims Review initiatives centered around handling of medical pre-payment and post-payment claims for accurate claim payment review through our suite of solutions
• Provide documentation for system/process updates and existing system functionality for reference by operationsand alternate teams
• Work closely with Product Management, Development, QA and UAT to ensure requirements are realized properly upon release to production
• Assist in providing training to operations on newly released items
• Recommend process, workflow and efficiency improvements while keeping the team informed on upcoming product development improvementsand new product solutions being taken to market
• Draft and send release notes and organize user requirements by scheduling meetings with appropriate stakeholders to track and manage accordinglyQualifications
  • Basic or advanced understanding of payment integrity, claim processing and/or revenue cycle for healthcare claims
  • Understanding of medical coding and medical claims
  • Ability to see the big picture and learn new processes, technologies and envision how they could benefit Zelis
  • Ability to partner with one or more Product Owners on key initiatives and prioritization efforts
  • Project Management experience; ability to drive output from others without direct supervisory responsibility
  • Excellent problem solving and analytical skills
  • Ability to prioritize and manage multiple concurrent projects
  • Moderate to advanced experience with Microsoft Office Suite, JIRA + Confluence#LI-RZ1#LI-HybridAs a leading payments company in healthcare, we guide, price, explain, and pay for care on behalf of insurers and their members. We're Zelis in our pursuit to align the interests of payers, providers, and consumers to deliver a better financial experience and more affordable, transparent care for all. We partner with more than 700 payers, including the top-5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, over 4 million providers, and 100 million members, enabling the healthcare industry to pay for care, with care. Zelis brings adaptive technology, a deeply ingrained service culture, and a comprehensive navigation through adjudication and payment platform to manage the complete payment process.Commitment to Diversity, Equity,Inclusion, and BelongingAt Zelis, we champion diversity, equity, inclusion, and belonging in all aspects of our operations. We embrace the power of diversity and create an environment where people can bring their authentic and best selves to work. We know that a sense of belonging is key not only to your success at Zelis, but also to your ability to bring your best each day.Equal Employment Opportunity Zelis is proud to be an equal opportunity employer. All applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.We encourage members of traditionally underrepresented communities to apply, even if you do not believe you 100% fit the qualifications of the position, including women, LGBTQIA people, people of color, and people with disabilities. Accessibility SupportWe are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email SCAM ALERT: There is an active nationwide employment scam which is now using Zelis to garner personal information or financial scams. This site is secure, and any applications made here are with our legitimate partner. If you're contacted by a Zelis Recruiter, please ensure whomever is contacting you truly represents Zelis Healthcare. We will never asked for the exchange of any money or credit card details during the recruitment process. Please be aware of any suspicious email activity from people who could be pretending to be recruiters or senior professionals at Zelis.

Keywords: Zelis Healthcare, LLC, Town-n-Country , Business Analyst - ECR, Professions , Saint Petersburg, Florida