Title : Payer Claim Business Analyst
Job Summary
We are seeking an experienced Healthcare Payer Claim Business Analyst to join our team. The successful candidate will play a key role in analyzing and improving claims processing, ensuring compliance with regulatory requirements, and driving business growth.
Key Responsibilities
1. Analyze claims data to identify trends, issues, and opportunities for process improvements.
2. Collaborate with stakeholders to understand business requirements and develop solutions to improve claims processing efficiency and accuracy.
3. Design and implement data analytics and reporting to track key performance indicators (KPIs) and monitor claims processing.
4. Conduct root cause analysis of claims issues and develop corrective action plans.
5. Develop and maintain documentation of claims processes, procedures, and policies.
6. Collaborate with cross-functional teams, including claims processing, underwriting, and provider relations.
7. Stay up-to-date with regulatory changes and industry trends impacting claims processing.
Requirements
1. Minimum 3-5 years of experience in healthcare claims processing or business analysis.
2. Strong analytical and problem-solving skills.
3. Excellent communication and interpersonal skills.
4. Experience with data analysis and reporting tools (e.g., SQL, Excel)
5. Knowledge of healthcare claims processing regulations (e.g., HIPAA, CMS).
6. Certification in healthcare analytics or business analysis (e.g., CBAP, CCBA) a plus.
Skills
1. Strong analytical and problem-solving skills.
2. Excellent communication and interpersonal skills.
3. Ability to work in a fast-paced environment.
4. Strong attention to detail.
5. Experience with project Management
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