Job Description

Role: Jr. Business System Analyst with Health Insurance
Location: Philadelphia, PA / Hybrid

Duration: 12+ months
Contract: W2

Department: Health Insurance

Job Description:

Skills: Strong SQL, Interoperability, Data Exchanges Standards (HL7, FHIR, CDA, API, EDI), Clinical Data Terminologies (SNOMED, CPT, LOINC), Healthcare Payer Domain (Prior Authorizations, Claims, Clinical Data exchange).

Responsibilities:

• Requirements Gathering: Collaborate with stakeholders to understand and document business requirements related to healthcare claims processing.
• System Analysis: Analyse existing systems and processes to identify areas for improvement and ensure they meet business needs.
• Process Modelling: Develop and document process models to illustrate current and future states of the claims processing workflow.
• Data Analysis: Perform data analysis to support decision-making and identify trends or issues in claims data.
• Solution Design: Work with IT teams to design and implement system solutions that improve efficiency and accuracy in claims processing.
• Testing and Validation: Develop test plans and conduct system testing to ensure solutions meet business requirements and are free of defects.
• Training and Support: Provide training and support to end-users on new systems and processes.
• Compliance: Ensure that all systems and processes comply with healthcare regulations and standards.

Skills:

• Critical Thinking: Ability to analyze complex problems and develop effective solutions.
• Technical Proficiency: Familiarity with healthcare claims systems, databases, and software tools.
• Communication: Strong verbal and written communication skills to interact with stakeholders and document requirements.
• Project Management: Ability to manage multiple projects and deadlines effectively.
• Attention to Detail: Ensuring accuracy in data analysis and system documentation.
• Collaboration: Work effectively with cross-functional teams, including IT, operations, and compliance departments.

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.

• Dice Id: 90915884
• Position Id: 8503842

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