Senior Business Analyst – Claims Operations

Job not on LinkedIn

November 25

❄️ Minnesota – Remote

Although this job is listed in Minnesota, this company may be open to hiring remote in other states.

💵 $76k - $98k / year

⏰ Full Time

🟠 Senior

🧐 Business Analyst

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HealthEZ

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Healthcare Insurance • B2B • HR Tech

HealthEZ is a third-party administrator that designs and administers self-funded employee health benefit plans for employers and brokers. The company focuses on customized plan design, cost containment (including reference-based pricing and prescription management), provider network management, and 24/7 member support, backed by mobile and online tools to improve member experience and reduce healthcare spending.

51 - 200 employees

Founded 1982

⚕️ Healthcare Insurance

🤝 B2B

👥 HR Tech

📋 Description

• Gather and develop business requirements to ensure claim processing produces the desired outcomes. • Build claim requirements and provide to other departments, vendors, and key stakeholders initiating other projects. • Develop claim test scenarios, procedures, and plans. • Analyze current business practices and systems and develop plans to optimize both practices and systems. • Document results, findings, options, and proposed solution(s) with comparison to current state and changes required. • Complete test procedures in the various test environments and validate specific outcomes in production. • Lead the investigation of reported incidents and perform root cause analysis. • Collaborate and coordinate with cross-functional teams to propose actionable solutions. • Accountable to resolve issues, defects, and concerns related to testing. • Analyze large data sets to find efficiencies and make recommendations to improve claims adjudication accuracy and timeliness. • Effectively communicate with team members, vendors, and stakeholders. • Oversee the test environments in collaboration with Plan build, IT and external vendors.

🎯 Requirements

• 3-5 years of Business Analyst experience supporting healthcare claims processing • BA degree or equivalent experience • Strong knowledge of Healthcare claims lifecycle • Virtual Benefits Administrator (VBA) knowledge or proven experience in learning claims adjudication platforms • Proven ability to effectively communicate with stakeholders • Self-starter and the ability to work independently

🏖️ Benefits

• health benefits • retirement plan (401k) • paid time away • paid leaves (including paid parental leave)