Senior Business Systems Analyst - Payment Integrity

Job Description

What You'll Do

• Provide advanced technical knowledge and support in system/application and procedural issues to the business and IT
• Use judgment and initiative to review, analyze and develop solutions and applicable business processes for business systems while identifying and quantifying the business impact of those solutions to ensure quality, cost effectiveness, timeliness and customer service, including the resolution of large, complex production system problems
• Provide systems analysis expertise and regularly considers the business implications of the application of technology to the current business environment
• Coordinate ongoing user support for ad hoc questions, inquiries, and service requests
• Ensure efficiency of reporting and data tools for supported business area use and for trend analysis
• Coordinate the development of system support processes with IT; coordinate daily to resolve production support issues, including application failures and user errors; document, track and report all system support activities
• Work collaboratively on projects and initiatives with the business and IT to test and implement long-term solutions by eliciting and documenting business requirements and preparing appropriate functional specifications while considering technical capabilities of the system/application and ensuring an integrated approach is used
• Act as Business Lead/Coordinator on large, complex departmental and/or some corporate projects/initiatives
• Facilitates project including intake, scheduling of projects, implementation, post-implementation support, and review and approve technical specifications
• Serve as point of contact for business testing activities and influence testing strategy to ensures testing will appropriately meet business requirements
• Analyze and verify results for accuracy, relevance and completeness. Provide impact assessments and make recommendations to the business owner regarding issues, risks, etc
• Train/coach others on appropriate testing protocol, execution and test plan creation
• Assist IT and help identify business area impacts for hardware and software upgrades, security changes, and architectural enhancements as needed
• Configure and maintain critical system tables and data elements across multiple system environments
• Analyze, develop and implement configuration changes to improve system performance and user efficiency

What You'll Bring

• Bachelor's degree or advanced degree (where required)
• 5+ years of experience in related field
• In lieu of degree, 7+ years of experience in related field

Bonus Points

• Advanced knowledge of claims adjudication lifecycle
• Familiarity with Payment Integrity programs and/or Pareo software

What You’ll Get

• The opportunity to work at the cutting edge of health care delivery with a team that’s deeply invested in the community 

• Work-life balance, flexibility, and the autonomy to do great work  

• Medical, dental, and vision coverage along with numerous health and wellness programs  

• Parental leave and support plus adoption and surrogacy assistance  

• Career development programs and tuition reimbursement for continued education  

• 401k match including an annual company contribution  

• Learn more  

Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.

*Based on annual corporate goal achievement and individual performance.

Skills

Originally posted on Himalayas